Primary thinning of the myocutaneous vastus lateralis flap

To expand the indicational spectrum of the myocutaneous vastus lateralis fl ap, which is often too voluminous for intraoral application, primary thinni ng of the fat and muscle component of this microsurgical transplant was per formed in 14 patients. The surgical technique includes subfascial localizat ion of at least one myocutaneous perforating vessel of the lateral cicumfle x femoral artery and its dissection through the fascia. muscles and fatty t issue up to the skin. The epifascial fatty tissue is completely removed exc ept for a 1-2 cm wide cuff around the perforating vessel. The thinning tech nique was used for covering 10 intraoral and 4 extraoral defects and enable d the raising of skin flaps with a thickness of 4 mm even in obese patients . The vessel pedicle length of the thinned flaps was between 12 and 16 cm, flap size varied between 4X5 and 9X15 cm and the donor sites were directly closed. In one case, there was a partial necrosis (20%), but the other flap s healed without complications. The described method allows the raising of thick myocutaneous as well as thin skin flaps from the same donor region.