Extended approach to the vascular pedicle of the gracilis muscle flap: anatomical and clinical study.


: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.


Plast Reconstr Surg


Hasen KV,Gallegos ML,Dumanian GA




Has Abstract


2003-06-01 00:00:00












  • Speech results of the Zürich approach in the treatment of unilateral cleft lip and palate.

    abstract::The purpose of this study was to describe perceptually the speech articulation, voice quality, and velopharyngeal competency of subjects with complete unilateral cleft lip and palate treated by the Zürich approach. The mean age of the 37 subjects was 10.5 years. Although only one subject had had secondary palatal mana...

    journal_title:Plastic and reconstructive surgery

    pub_type: 杂志文章


    authors: Van Demark DR,Gnoinski W,Hotz MM,Perko M,Nussbaumer H

    更新日期:1989-04-01 00:00:00

  • The incidence of late cephalohematoma following craniofacial surgery.

    abstract:BACKGROUND:Cranial vault remodeling procedures are carried out for both syndromic and nonsyndromic craniosynostosis as well as to correct some acquired deformities of the cranial vault. These procedures improve not only cosmesis but also neurological symptoms. The purpose of this study was to determine the incidence of...

    journal_title:Plastic and reconstructive surgery

    pub_type: 杂志文章


    authors: Ghali S,Knox KR,Boutros S,Thorne CH,McCarthy JG

    更新日期:2007-09-15 00:00:00

  • Medial epicanthoplasty using the skin redraping method.

    abstract:BACKGROUND:The presence of epicanthal folds and the absence of supratarsal folds are unique features in the eyelids of Asians. The resulting appearance leads many to seek cosmetic improvement in the medial canthal area. Although many techniques have been described for the elimination of epicanthal folds, scarring and d...

    journal_title:Plastic and reconstructive surgery

    pub_type: 杂志文章


    authors: Oh YW,Seul CH,Yoo WM

    更新日期:2007-02-01 00:00:00

  • The Pushback Pharyngeal Flap: An 18-Year Experience.

    abstract:BACKGROUND:The pharyngeal flap is one of the oldest and most popular techniques for correction of velopharyngeal insufficiency. The authors describe a large series using a technique that combines a pharyngeal flap with a palate pushback to avoid common causes of operative failure while restoring the velopharyngeal mech...

    journal_title:Plastic and reconstructive surgery

    pub_type: 杂志文章


    authors: Rochlin DH,Mittermiller PA,Sheckter CC,Menard RM

    更新日期:2019-06-01 00:00:00

  • Decision-Making in Middle Vault Reconstruction following Dorsal Hump Reduction in Primary Rhinoplasty.

    abstract:BACKGROUND:Dorsal hump reduction during open rhinoplasty disrupts the continuity between the upper lateral cartilages and the dorsal septum. Options to reconstitute the midvault include primary closure of the upper lateral cartilages to the dorsal aspect of the septum, placement of spreader grafts, and creation of spre...

    journal_title:Plastic and reconstructive surgery

    pub_type: 杂志文章


    authors: Avashia YJ,Marshall AP,Allori AC,Rohrich RJ,Marcus JR

    更新日期:2020-06-01 00:00:00

  • Sapphire tip technology for YAG laser excisions in plastic surgery.

    abstract::Thirty-two patients with a variety of vascular and nonvascular lesions have been resected over a 3-year period with the neodymium:YAG laser utilizing sapphire peripheral scalpel devices. These innovative peripheral devices concentrate the YAG laser energy to a small area at the end of the scalpel, providing precise in...

    journal_title:Plastic and reconstructive surgery

    pub_type: 杂志文章


    authors: Apfelberg DB,Maser MR,Lash H,White DN

    更新日期:1989-08-01 00:00:00

  • Pediatric Tissue Expansion: Predictors of Premature Expander Removal in a Single Surgeon's Experience with 472 Expanders.

    abstract:BACKGROUND:Tissue expansion is used for soft-tissue reconstruction in pediatric patients. The expansion process can be complicated by infection and extrusion, leading to premature expander removal. The aim of this study was to identify risk factors associated with premature expander removal caused by infection or extru...

    journal_title:Plastic and reconstructive surgery

    pub_type: 杂志文章


    authors: Wang HD,Ibrahim Z,Quan A,Bai J,Ostrander BT,Redett RJ

    更新日期:2020-03-01 00:00:00

  • Surgical Treatment and Visual Outcomes of Adult Orbital Roof Fractures.

    abstract:BACKGROUND:Fractures of the orbital roof require high-energy trauma and have been linked to high rates of neurologic and ocular complications. However, there is a paucity of literature exploring the association between injury, management, and visual prognosis. METHODS:The authors performed a 3-year retrospective revie...

    journal_title:Plastic and reconstructive surgery

    pub_type: 杂志文章


    authors: Gebran SG,Lopez J,Wasicek PJ,Elegbede A,Rasko YM,Liang F,Nam AJ,Manson PN,Grant MP

    更新日期:2021-01-01 00:00:00

  • Tolerance induction in composite facial allograft transplantation in the rat model.

    abstract::Clinical application of composite tissue allograft transplants opened discussion on the restoration of facial deformities by allotransplantation. The authors introduce a hemifacial allograft transplant model to investigate the rationale for the development of functional tolerance across the major histocompatibility co...

    journal_title:Plastic and reconstructive surgery

    pub_type: 杂志文章


    authors: Demir Y,Ozmen S,Klimczak A,Mukherjee AL,Siemionow M

    更新日期:2004-12-01 00:00:00

  • Rapid histochemical identification of motor and sensory fascicles: preparation of solutions.

    abstract::We report a rapid and inexpensive staining method for identification of motor and sensory fibers within 1 hour (intraoperatively). This method should be easy to use in any hospital where frozen histologic sectioning is available. ...

    journal_title:Plastic and reconstructive surgery

    pub_type: 杂志文章


    authors: Kanaya F,Jevans AW

    更新日期:1992-09-01 00:00:00

  • Acute intraoperative arterial lengthening for closure of large vascular gaps.

    abstract::This study demonstrates the feasibility of acute extraluminal expansion to elongate arteries intraoperatively in order to overcome defects too large to be repaired primarily. Twenty Sprague-Dawley rats were divided into two groups: an expander-elongation group and a nonexpanded control group of 10 rats each. Arterial ...

    journal_title:Plastic and reconstructive surgery

    pub_type: 杂志文章


    authors: Cohen BE,Ruiz-Razura A

    更新日期:1992-09-01 00:00:00

  • Revising the nasal tip: a new approach.

    abstract::After a very cautious dissection, the crossing of cartilages is going to produce a "spring effect" which, in pushing them to the right position, will consequently correct the pinch. This is a simple procedure, indicated only for nose tips or, if associated with other techniques, to correct secondary rhinoplasty patien...

    journal_title:Plastic and reconstructive surgery

    pub_type: 杂志文章


    authors: Ribeiro L

    更新日期:1989-10-01 00:00:00

  • The Ideal Buttock Size: A Sociodemographic Morphometric Evaluation.

    abstract:BACKGROUND:Perception of beauty is influenced by geographic, ethnic, cultural, and demographic factors. However, objective measurements remain the foundation for aesthetic evaluations. In the quest to better define the "ideal" female buttock, this study assumes interdependence among variables such as country of residen...

    journal_title:Plastic and reconstructive surgery

    pub_type: 杂志文章


    authors: Heidekrueger PI,Sinno S,Tanna N,Szpalski C,Juran S,Schmauss D,Ehrl D,Ng R,Ninkovic M,Broer PN

    更新日期:2017-07-01 00:00:00

  • Breast reconstruction using the sensate latissimus dorsi musculocutaneous flap.

    abstract::The authors performed immediate breast reconstruction on four patients using a sensate latissimus dorsi musculocutaneous flap accompanied by neurorrhaphy during the past 6 years. In the neurorrhaphy, the lateral cutaneous branch of the dorsal primary divisions of the seventh thoracic nerve, which controls the sensatio...

    journal_title:Plastic and reconstructive surgery

    pub_type: 杂志文章


    authors: Yano K,Hosokawa K,Takagi S,Nakai K,Kubo T

    更新日期:2002-05-01 00:00:00

  • Superficial Circumflex Iliac Artery Perforator Flap: An Anatomical Study of the Correlation of the Superficial and the Deep Branches of the Artery and Evaluation of Perfusion from the Deep Branch to the Sartorius Muscle and the Iliac Bone.

    abstract:BACKGROUND:Harvesting the sartorius muscle and the iliac bone with a superficial circumflex iliac artery (SCIA) perforator flap can be a challenging procedure. The aim of this study was to describe the anatomical topology of the deep branch of the SCIA in fresh cadavers, which has not been reported in detail. METHODS:...

    journal_title:Plastic and reconstructive surgery

    pub_type: 杂志文章


    authors: Yoshimatsu H,Steinbacher J,Meng S,Hamscha UM,Weninger WJ,Tinhofer IE,Harima M,Fuse Y,Yamamoto T,Tzou CHJ

    更新日期:2019-02-01 00:00:00

  • Alternatives to subcutaneous mastectomy.

    abstract::It is our belief that subcutaneous mastectomy often leads to complications, with poor results. In addition, because a considerable amount of breast tissue may be left behind, its value as a prophylactic operation must be questioned. Two alternatives are presented. In our experience, these lead to fewer complications w...

    journal_title:Plastic and reconstructive surgery

    pub_type: 杂志文章


    authors: Hoffman S,Simon BE,Kahn S

    更新日期:1979-08-01 00:00:00

  • The Role of Military Plastic Surgeons in the Management of Modern Combat Trauma: An Analysis of 645 Cases.

    abstract:BACKGROUND:Plastic surgery has historically been linked to war. Between 2008 and the end of combat operations in Afghanistan in 2014, British military plastic surgeons formed part of the multinational military surgical team at the Role 3 Medical Treatment Facility, Camp Bastion, Helmand Province. The present study aime...

    journal_title:Plastic and reconstructive surgery

    pub_type: 杂志文章


    authors: Maitland L,Lawton G,Baden J,Cubison T,Rickard R,Kay A,Hettiaratchy S

    更新日期:2016-04-01 00:00:00

  • Treatment of burn alopecia with tissue expanders in children.

    abstract::During the past 18 months, 60 tissue expanders were utilized in the reconstruction of 42 children with burn alopecia of the scalp not amenable to a single excision and primary closure at the Shriners Burns Institute in Galveston, Texas. The children were grouped according to the degree of alopecia. All patients with d...

    journal_title:Plastic and reconstructive surgery

    pub_type: 杂志文章


    authors: Buhrer DP,Huang TT,Yee HW,Blackwell SJ

    更新日期:1988-04-01 00:00:00

  • A molecular analysis of the isolated rat posterior frontal and sagittal sutures: differences in gene expression.

    abstract::Although it is one of the most commonly occurring craniofacial congenital disabilities, craniosynostosis (the premature fusion of cranial sutures) is nearly impossible to prevent because the molecular mechanisms that regulate the process of cranial suture fusion remain largely unknown. Recent studies have implicated t...

    journal_title:Plastic and reconstructive surgery

    pub_type: 杂志文章


    authors: Spector JA,Mehrara BJ,Greenwald JA,Saadeh PB,Steinbrech DS,Smith LP,Longaker MT

    更新日期:2000-09-01 00:00:00

  • Subfascial periareolar augmentation mammaplasty.

    abstract::Subfascial placement of implants was introduced 3 years ago. Collected data reveal very promising short-term and long-term results in comparison with subglandular and subpectoral positioned implants. The clinical experiences of 69 breast augmentations in the subfascial position are reported. The indications for this t...

    journal_title:Plastic and reconstructive surgery

    pub_type: 杂志文章


    authors: Stoff-Khalili MA,Scholze R,Morgan WR,Metcalf JD

    更新日期:2004-10-01 00:00:00

  • Facial asymmetry: three-dimensional analysis using laser surface scanning.

    abstract::This study evaluates six different techniques with respect to their ability to quantitatively describe facial asymmetry in three dimensions. Three-dimensional facial images were acquired using a Cyberware 3030RGB laser surface scanner. Image processing was performed on a Silicon Graphics Indigo computer workstation. T...

    journal_title:Plastic and reconstructive surgery

    pub_type: 杂志文章


    authors: O'Grady KF,Antonyshyn OM

    更新日期:1999-09-01 00:00:00

  • Autologous Fat Injection versus Lundborg Resection Arthroplasty for the Treatment of Trapeziometacarpal Joint Osteoarthritis.

    abstract:BACKGROUND:Various operative approaches exist for treatment of trapeziometacarpal joint osteoarthritis. The aim of this study was to compare the results of Lundborg resection arthroplasty with solely autologous fat injection. METHODS:Twenty-one patients with symptomatic osteoarthritis of the trapeziometacarpal joint (...

    journal_title:Plastic and reconstructive surgery

    pub_type: 杂志文章


    authors: Erne HC,Cerny MK,Ehrl D,Bauer AT,Schmauss V,Moog P,Broer PN,Loew S,Schmauss D

    更新日期:2018-01-01 00:00:00

  • Comparison of Outcomes following Autologous Breast Reconstruction Using the DIEP and Pedicled TRAM Flaps: A 12-Year Clinical Retrospective Study and Literature Review.

    abstract:BACKGROUND:There are few studies that compare the deep inferior epigastric artery perforator (DIEP) flap to the pedicled transverse rectus abdominis myocutaneous (pTRAM) flap for use in reconstructive breast surgery. The authors examined four factors that aid in decision-making: donor-site morbidity, need for surgery r...

    journal_title:Plastic and reconstructive surgery

    pub_type: 杂志文章,评审


    authors: Knox ADC,Ho AL,Leung L,Tashakkor AY,Lennox PA,Van Laeken N,Macadam SA

    更新日期:2016-07-01 00:00:00

  • Pyriform augmentation as an ancillary procedure in facial rejuvenation surgery.

    abstract::A patient is presented in whom augmentation of the pyriform aperture of the maxilla was performed with porous hydroxyapatite in concert with a face and brow lift. Basic research has recently shown that remodeling of the facial skeleton continues throughout life and that this remodeling process leads to changes in the ...

    journal_title:Plastic and reconstructive surgery

    pub_type: 杂志文章


    authors: Pessa JE,Peterson ML,Thompson JW,Cohran CS,Garza JR

    更新日期:1999-02-01 00:00:00

  • The evolution of the Hughes tarsoconjunctival flap for the lower eyelid reconstruction.

    abstract::The Hughes tarsoconjunctival flap was initially described in 1937. This flap is best used for reconstructing full-thickness defects involving the central portion of the lower eyelid. The evolution of this flap over the last 60 years is outlined. Several important modifications are presented; these modifications lead t...

    journal_title:Plastic and reconstructive surgery

    pub_type: 历史文章,杂志文章


    authors: Rohrich RJ,Zbar RI

    更新日期:1999-08-01 00:00:00

  • SMAD6 Genotype Predicts Neurodevelopment in Nonsyndromic Craniosynostosis.

    abstract:BACKGROUND:De novo or rare transmitted mutations in the SMAD6 gene affect 7 percent of midline nonsyndromic synostosis patients. This study aimed to determine the neurocognitive sequelae of SMAD6 synostosis. METHODS:Nonsyndromic synostosis patients 6 years or older with SMAD6 mutations and non-SMAD6 nonsyndromic synos...

    journal_title:Plastic and reconstructive surgery

    pub_type: 杂志文章


    authors: Wu RT,Timberlake AT,Abraham PF,Gabrick KS,Lu X,Peck CJ,Sawh-Martinez RF,Steinbacher DM,Alperovich MA,Persing JA

    更新日期:2020-01-01 00:00:00

  • S-shaped repair of the unilateral cleft lip.

    abstract::A modification of Tennison's operation for closure of a cleft lip is presented. The modification entails the use of X-shaped incision lines and a piece of lead rather than a wire. ...

    journal_title:Plastic and reconstructive surgery

    pub_type: 杂志文章


    authors: Stenström SJ

    更新日期:1976-12-01 00:00:00

  • Evidence-Based Perioperative Nutrition Recommendations: Optimizing Results and Minimizing Risks.

    abstract::Plastic surgery patients span the nutritional spectrum from generally healthy, nutritionally competent patients to inherently catabolic, nutritionally deficient, and chronic wound patients. Therefore, plastic and reconstructive surgery affords the opportunity to investigate the impact of nutrition across a heterogeneo...

    journal_title:Plastic and reconstructive surgery

    pub_type: 杂志文章,评审


    authors: Knackstedt R,Oliver J,Gatherwright J

    更新日期:2020-08-01 00:00:00

  • Electrical stimulation of onlay bone grafts.

    abstract::An animal model was developed to determine the ability of capacitively coupled electrical fields to enhance onlay bone graft survival in the craniofacial skeleton. Fifteen male New Zealand white rabbits were divided into control and stimulated groups. Blocks of iliac bone were transplanted as onlay grafts to the mandi...

    journal_title:Plastic and reconstructive surgery

    pub_type: 杂志文章


    authors: Stalnecker MC,Whitaker LA,Brighton CT

    更新日期:1988-10-01 00:00:00

  • Impact of perforator mapping using multidetector-row computed tomographic angiography on free thoracodorsal artery perforator flap transfer.

    abstract:BACKGROUND:The preoperative localization of thoracodorsal artery perforators has been a challenge because of their topographic variation. METHODS:From November of 2005 to January of 2007, 25 patients underwent free thoracodorsal artery perforator flap transfer for reconstruction of the lower extremities (22 flaps) and...

    journal_title:Plastic and reconstructive surgery

    pub_type: 杂志文章


    authors: Mun GH,Kim HJ,Cha MK,Kim WY

    更新日期:2008-10-01 00:00:00