Abstract:
:Dissection of the proximal gracilis vascular pedicle proceeds in a dark tunnel-like space deep to the adductor longus. With the application of a previously described technique for an extended approach to the lateral arm free flap, the authors describe a novel technique that improves observation and thus facilitates dissection of the proximal gracilis vascular pedicle. A retrospective review of data for 18 consecutive patients who underwent gracilis muscle free flap harvesting with this modified technique between March of 1999 and October of 2001 was conducted, to assess flap viability and patient outcomes. A cadaveric dissection was also performed, to study the anatomical features of the region in depth and to test the proposed flap modification. After the standard incision has been made, the dominant pedicle is exposed on the medial aspect of the gracilis muscle, running in a fascial cleft between the adductor longus and the adductor magnus. Intramuscular branches to the adductor longus are divided. A space is bluntly created anterior and lateral to the adductor longus by separating the fibrous connections to the surrounding adductor and sartorius muscles on both sides of the vascular pedicle. The gracilis muscle is then divided and passed deep to the adductor longus, into this space. With this new position, the final dissection of the pedicle can easily be performed. The confluence of the venae comitantes is frequently encountered, providing a larger-caliber single vein for microvascular anastomosis. The ages of the patients ranged from 9 to 70 years. The majority (14 of 18 patients) had traumatic wounds. The free flap survival rate was 100 percent. One minor complication of a seroma at the donor site was observed. One major complication of venous thrombosis was detected on postoperative day 3, with complete flap salvage. No other complications were noted. This technique is safe and permits direct approach to and excellent observation of the proximal aspect of the gracilis pedicle, without the need for headlights or deep retractors. An additional benefit is the frequent finding of a single larger vein from the merging of the venae comitantes close to the deep femoral vessels.
journal_name
Plast Reconstr Surgjournal_title
Plastic and reconstructive surgeryauthors
Hasen KV,Gallegos ML,Dumanian GAdoi
10.1097/01.PRS.0000060114.95065.C5subject
Has Abstractpub_date
2003-06-01 00:00:00pages
2203-8issue
7eissn
0032-1052issn
1529-4242journal_volume
111pub_type
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journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章
doi:10.1097/00006534-199408000-00021
更新日期:1994-08-01 00:00:00
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journal_title:Plastic and reconstructive surgery
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doi:10.1097/00006534-198408000-00014
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journal_title:Plastic and reconstructive surgery
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journal_title:Plastic and reconstructive surgery
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abstract:BACKGROUND:Reconstruction of large full-thickness defects of the upper eyelids is challenging because of their complex anatomy and specialized functions. The authors present and discuss a new, simple surgical technique for upper eyelid reconstruction. This is a single-stage procedure and has produced satisfactory to ex...
journal_title:Plastic and reconstructive surgery
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journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章
doi:10.1097/01.prs.0000436843.15494.ad
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journal_title:Plastic and reconstructive surgery
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doi:10.1097/00006534-199502000-00021
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journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章
doi:10.1097/01.prs.0000133166.50279.7c
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pub_type: 杂志文章
doi:10.1097/PRS.0000000000001453
更新日期:2015-08-01 00:00:00
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journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章
doi:10.1097/PRS.0000000000005223
更新日期:2019-02-01 00:00:00
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pub_type: 共识发展会议,杂志文章
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pub_type: 杂志文章,评审
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doi:10.1097/00006534-198308000-00007
更新日期:1983-08-01 00:00:00
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journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章,评审
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journal_title:Plastic and reconstructive surgery
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doi:10.1097/00006534-199810000-00055
更新日期:1998-10-01 00:00:00
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journal_title:Plastic and reconstructive surgery
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更新日期:1993-10-01 00:00:00
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journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章
doi:10.1097/00006534-199005000-00003
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journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章
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更新日期:2007-11-01 00:00:00
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journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章
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更新日期:2010-05-01 00:00:00
abstract:BACKGROUND:Fat grafting may be beneficial in prosthetic reconstruction of irradiated tissues, but there is a paucity of data on the complication rates associated with this clinical scenario. METHODS:All consecutive patients who had undergone fat grafting and prosthetic reconstruction from 2010 to 2013 were enrolled. V...
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更新日期:2017-01-01 00:00:00
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journal_title:Plastic and reconstructive surgery
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journal_title:Plastic and reconstructive surgery
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journal_title:Plastic and reconstructive surgery
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journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章
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