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Related Experiment Video

Updated: Mar 9, 2026

Engineered Vascularized Muscle Flap
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Lower Extremity Reconstruction with Free Gracilis Flaps.

Michael J Franco1, Michael C Nicoson1, Rajiv P Parikh1

  • 1Division of Plastic and Reconstructive Surgery, Washington University School of Medicine, St. Louis, Missouri.

Journal of Reconstructive Microsurgery
|December 27, 2016
PubMed
Summary

The free gracilis flap is a reliable option for lower extremity reconstruction, offering a high success rate and minimal donor site issues. This technique effectively reconstructs defects, preserving limb function and patient quality of life.

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Area of Science:

  • Plastic Surgery
  • Orthopedic Surgery
  • Reconstructive Surgery

Background:

  • Advancements in lower extremity reconstruction include various flap techniques.
  • The free gracilis flap is highlighted for its ease of harvest, reliability, and low donor site morbidity.
  • It has become a preferred method for reconstruction in this study.

Purpose of the Study:

  • To evaluate the efficacy and outcomes of free gracilis flaps in lower extremity reconstruction.
  • To analyze demographic information, comorbidities, and secondary procedures associated with this technique.

Main Methods:

  • Retrospective review of a single surgeon's case series.
  • Analysis of 24 free gracilis flaps used for lower extremity reconstruction.
  • Data collected included patient demographics, injury-to-coverage time, flap outcomes, and secondary interventions.

Main Results:

  • A high success rate of 92% was observed for the 24 free gracilis flaps.
  • The overall limb salvage rate was also 92%, with one partial flap loss.
  • Complications included infection and donor site hematomas; four patients required secondary contouring procedures.

Conclusions:

  • The free gracilis flap is highly effective for reconstructing small to medium lower extremity defects.
  • This flap offers a high success rate and low donor site morbidity.
  • Natural muscle atrophy facilitates shoe fit, often reducing the need for secondary procedures.