ABSTRACT
While the gracilis muscle flap continues to be used for coverage of selected defects
and in specialized applications such as facial reanimation, the lack of reliability
of the distal skin component of the gracilis musculocutaneous flap has limited its
usefulness. Reliable distal skin and muscle viability are particularly important when
the gracilis musculocutaneous free flap is used in forearm flexorplasty. A method
for “turbo-charging” this flap, to improve distal reliability, is described. The anatomy
of 24 human lower extremities was studied, with respect to the arterial supply to
the distal gracilis muscle and distal medial thigh skin. A consistent septal branch,
originating from the superficial femoral artery proximal to the adductor canal, supplying
the distal gracilis muscle as well as the overlying skin, was identified in all extremities.
“Turbo-charging” via this vessel increases the reliability of both the distal skin
island and distal muscle of the gracilis myocutaneous flap and enhances its versatility,
when used as either a pedicle or free flap.
