gracilisflap

The gracilis flap is a surgical technique used in reconstructive plastic surgery. It involves transferring a portion of the gracilis muscle, a long, slender muscle located in the inner thigh, along with its blood supply and nerve, to another part of the body to restore function or appearance. This type of flap is known as a myocutaneous flap because it typically includes both muscle and skin.

The gracilis muscle is chosen for its length, thinness, and the reliable vascular supply it receives from the medial femoral circumflex artery. The flap can be harvested with varying amounts of overlying skin, depending on the reconstructive needs. Its versatility allows it to be used in a variety of reconstructive scenarios, including breast reconstruction, closure of large soft tissue defects, and reconstruction of the head and neck or perineal regions.

The procedure involves carefully dissecting the muscle and its vascular pedicle from the thigh. Once mobilized, the flap is tunneled to the recipient site and meticulously reconnected to local blood vessels to ensure its survival. The donor site in the thigh is typically closed primarily, leaving a linear scar. The gracilis flap can be used as a free flap, where the blood vessels are microscopically anastomosed to recipient vessels, or as a pedicled flap, where the muscle remains attached to its original blood supply and is tunneled to the defect. Its use can restore both bulk and, in some cases, function, such as voluntary movement if the nerve is successfully reinnervated.