The transversely split gracilis twin free flaps.

Area of Science:

• Reconstructive surgery
• Microsurgery
• Anatomy

Background:

• The gracilis muscle is a Class II muscle frequently utilized in free tissue transfer procedures.
• It possesses multiple secondary pedicles, with the first being the most reliable in location and size.
• Each pedicle can sustain a muscle segment, enabling the creation of multiple small flaps from one long muscle.

Purpose of the Study:

• To explore the potential of transversely splitting the gracilis muscle for reconstructive purposes.
• To evaluate the feasibility of using multiple gracilis muscle flaps to cover extensive or multiple defects.
• To assess the benefits of this technique in minimizing donor site morbidity compared to traditional methods.

Main Methods:

• Review of anatomical studies detailing the vascular supply and segmentation of the gracilis muscle.
• Analysis of previous surgical techniques involving gracilis muscle flaps, focusing on longitudinal splitting.
• Conceptualization and description of a transverse splitting technique for gracilis muscle flaps.

Main Results:

• The gracilis muscle's vascular anatomy supports the viability of multiple segments when supplied by their respective pedicles.
• Transverse splitting allows for the creation of several independent muscle flaps from a single gracilis muscle.
• This approach has been rarely documented but holds potential for covering multiple wounds simultaneously.

Conclusions:

• Transverse splitting of the gracilis muscle is a viable, yet underutilized, technique for generating multiple reconstructive flaps.
• This method can effectively address multiple recipient sites in a single patient, thereby reducing the need for multiple donor areas.
• Further clinical investigation is warranted to establish the efficacy and safety of transverse gracilis muscle flap harvesting.