Improving Skin Paddle Reliability and Muscle Gliding in Free Functional Gracilis Transfers.

Autor:	Vaile JR; From the Division of Plastic, Reconstructive, and Oral Surgery, Children's Hospital of Philadelphia, Philadelphia, Penn., Struble SL; From the Division of Plastic, Reconstructive, and Oral Surgery, Children's Hospital of Philadelphia, Philadelphia, Penn., Patel NK; From the Division of Plastic, Reconstructive, and Oral Surgery, Children's Hospital of Philadelphia, Philadelphia, Penn., Janes LE; Division of Plastic Surgery, Department of Surgery, Northwestern Feinberg School of Medicine, Chicago, Ill., Park ED; Department of Orthopedic Surgery, Shriners Children's Philadelphia, Philadelphia, Penn., Levin LS; Perelman School of Medicine at the University of Pennsylvania, Philadelphia, Penn.; Department of Orthopaedic Surgery, University of Pennsylvania, Philadelphia, Penn., Mendenhall SD; From the Division of Plastic, Reconstructive, and Oral Surgery, Children's Hospital of Philadelphia, Philadelphia, Penn.; Perelman School of Medicine at the University of Pennsylvania, Philadelphia, Penn.; Division of Orthopaedic Surgery, Children's Hospital of Philadelphia, Philadelphia, Penn.
Jazyk:	angličtina
Zdroj:	Plastic and reconstructive surgery. Global open [Plast Reconstr Surg Glob Open] 2024 Feb 07; Vol. 12 (2), pp. e5592. Date of Electronic Publication: 2024 Feb 07 (Print Publication: 2024).
DOI:	10.1097/GOX.0000000000005592
Abstrakt:	Free functional muscle transfer is an attractive option within reconstructive surgery when seeking to restore critical muscle function. The gracilis muscle has long been utilized for this purpose due to its expendability and consistent anatomy. Historically, survival of the skin overlying the distal one-third of the myocutaneous gracilis flap has been unpredictable. To address this, the myofasciocutaneous technique was developed, with prior studies demonstrating improved distal skin paddle viability with this approach; however, the mechanism is poorly defined. This study aimed to understand what factors contribute to survival benefit in myofasciocutaneous gracilis flaps. Using cadaveric dissections followed by latex dye injections, we discuss the creation of a deep fascial sheath that contains a rich vascular network and permits adhesion-free excursion at the recipient site. This study advances our understanding of the myofasciocutaneous gracilis flap and provides wider clinical applicability in free functional muscle transfer. Competing Interests: Shaun D. Mendenhall is an educational consultant for PolyNovo, which does not relate to the content of this article. All the other authors have no financial interest in relation to the content of this article. This study was funded by a research grant from the Edwin & Fannie Gray Hall Center for Human Appearance. (Copyright © 2024 The Authors. Published by Wolters Kluwer Health, Inc. on behalf of The American Society of Plastic Surgeons.)
Databáze:	MEDLINE
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