THE EXTENDED GRACILIS MUSCLE FLAP FOR RECONSTRUCTION OF THE LOWER LEG

The width of the gracilis muscle was measured before and after removal of the epimysium in 10 fresh cadavers, The average extent of muscle w idening achieved by epimysium removal was over 100% (mean 112.6%; stan dard deviation 11.9%), This extended muscle flap enabled us to cover s uccessfully even large soft tissue defects measuring up to 300 cm(2). In 27 consecutive patients, soft tissue defects of the lower leg with exposed bone have been repaired by free tissue transfer of a gracilis muscle flap, covered with split skin grafts, The advantages of the gra cilis muscle flap were the low donor site morbidity with almost no rec ognisable functional loss, the easy surgical access, the thin and flat shape of the muscle, and its adequate size after excision of the epim ysium, Reconstruction with a gracilis muscle flap resulted in an incon spicuous, stable, and flat contour of the lower leg, The entire length of the vascular pedicle of the gracilis muscle was easily harvested i n our patients by routinely dissecting the pedicle on both sides of th e adductor longus muscle.