The vertically oriented free myocutaneous gracilis flap in head and neck reconstruction Journal Article
| Authors: | Kropf, N.; Cordeiro, C. N.; McCarthy, C. M.; Hu, Q. Y.; Cordeiro, P. G. |
| Article Title: | The vertically oriented free myocutaneous gracilis flap in head and neck reconstruction |
| Abstract: | Oncologic resections in the head and neck can result in a variety of complex defects. Many free tissue transfers have been described for soft-tissue reconstruction in this area. The pedicled, vertical gracilis myocutaneous flap has been well described for use in the perineum, but is rarely used as a free tissue transfer because of previously documented unreliability of the skin island. The objective of this study was thus to review a single authors experience with reconstruction of complex head and neck defects using the vertically oriented free myocutaneous gracilis flap. A retrospective review of all head and neck reconstructions at a major cancer center from 2003-2006 was performed. Demographic, oncologic and reconstructive data were retrieved from a prospectively maintained clinical database. Ten patients (mean age, 57 years; range, 33-84 years) with complex defects of the head and neck were reconstructed using a gracilis myocutaneous flap with a vertically oriented skin paddle. Seven patients had a malignant skin tumor; 3 patients had a parotid gland tumor. Mean surface area requirements were 88.6 cm. Composite resections were common and included skin, facial nerve, mandibular and/or temporal bone, partial glossectomy, parotidectomy, and/or orbital exenteration. Six patients had a history of prior irradiation; 6 patients received postoperative radiotherapy. Mean follow-up was 8 months (range, 2-20 months). Total flap survival was 100%. There were no partial flap losses. Primary wound healing occurred in all cases. The vertically oriented free myocutaneous gracilis flap is a reliable option for reconstruction of moderate volume and surface area defects in the head and neck. It represents an underutilized flap that should be more commonly considered for soft-tissue reconstruction of complex defects in the head and neck. Copyright © 2008 by Lippincott Williams & Wilkins. |
| Keywords: | adult; clinical article; aged; aged, 80 and over; middle aged; retrospective studies; head and neck surgery; plastic surgery; surgical flaps; cancer radiotherapy; postoperative care; follow up; skin cancer; data base; medical record review; retrospective study; wound healing; graft failure; head and neck neoplasms; graft survival; glossectomy; head and neck tumor; injury; mandible; evisceration; facial nerve; parotidectomy; gracilis flap; wounds and injuries; free gracilis myocutaneous flap; head and neck reconstruction; parotid gland tumor; temporal bone |
| Journal Title: | Annals of Plastic Surgery |
| Volume: | 61 |
| Issue: | 6 |
| ISSN: | 0148-7043 |
| Publisher: | Lippincott Williams & Wilkins |
| Date Published: | 2008-12-01 |
| Start Page: | 632 |
| End Page: | 636 |
| Language: | English |
| DOI: | 10.1097/SAP.0b013e31816d82c0 |
| PUBMED: | 19034078 |
| PROVIDER: | scopus |
| DOI/URL: | |
| Notes: | --- - "Cited By (since 1996): 5" - "Export Date: 17 November 2011" - "CODEN: APCSD" - "Source: Scopus" |
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