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Free gracilis flap an option in breast reconstruction when abdominal site unavailable

Researchers preferred the vertical pattern with a free gracilis flap for patients undergoing breast reconstruction.

The vertical pattern avoids some problems associated with transverse patterns, such as scar migration and contraction, and labial spreading, according to researchers.

In the retrospective case series, 22 patients underwent secondary breast reconstruction with gracilis myocutaneous flaps, 14 of which had previous breast reconstruction.

Six patients had bilateral reconstruction and five underwent unilateral reconstruction with bilateral stacked gracilis flaps.

In four flaps, the skin paddle was transverse and for 29 flaps utilized a vertical skin paddle.

One flap loss occurred in addition to two occurrences of fat necrosis, one infection and one seroma.

Thirteen of the 22 patients underwent fat grafting to the reconstructed breast to improve contour or volume.

The harvested skin paddle was a large as 15 cm x 20 cm and in some patients the flap extended down to the distal thigh.

The mean flap weight was 342 g for vertical skin flaps and 268 g in transverse skin pattern flaps.

In the researchers’ opinions, a vertical pattern should be considered the first choice for gracilis flap breast reconstruction. – by Abigail Sutton

Disclosure: The researchers reported no relevant financial disclosures.