Muscle free flaps with full-thickness skin grafting: Improved contour overtraditional musculocutaneous free flaps

Occasionally, the aesthetic contour of a musculocutaneous flap can be impro ved by using the skin paddle as a full-thickness skin graft to cover the fr ee muscle flap. In three patients, traditional musculocutaneous free flap c overage of wounds would have resulted in excess soft tissue bulk. To optimi ze final contour, the subcutaneous tissue was excised, and the skin replace d as a full-thickness skin graft. Problems with postoperative flap monitori ng and skin graft take were not encountered. This technique offers the micr osurgeon a simple method to optimize the aesthetic results of composite fre e tissue transfer. (C) 2001 Wiley-Liss, Inc.