Innervated Pedicled Gracilis Flap for Dynamic Abdominal Wall Reconstruction

Area of Science:

• Reconstructive Surgery
• Plastic Surgery
• Trauma Surgery

Background:

• Full-thickness abdominal wall defects present significant reconstructive challenges.
• Current methods often rely on flaps, but dynamic reconstruction after severe trauma is less explored.
• The gracilis flap is documented for hernia repair with intact abdominal muscles.

Purpose of the Study:

• To describe a novel surgical technique for dynamic abdominal wall reconstruction using an innervated gracilis flap.
• To evaluate the feasibility and outcomes of this technique in patients with severe abdominal tissue loss.
• To highlight the potential of the gracilis flap in restoring both structural integrity and dynamic function.

Main Methods:

• Harvesting the gracilis flap while preserving its neurovascular pedicle.
• Tunneling the flap under the adductor longus to cover the abdominal defect.
• Ensuring no tension on the pedicle to maintain viability and function.

Main Results:

• Successful restoration of the musculofascial abdominal wall integrity.
• Achieved dynamic muscle function and support in the reconstructed abdominal wall.
• Demonstrated potential for minimal donor-site morbidity and reduced hernia recurrence risk.

Conclusions:

• The innervated gracilis flap offers a viable and effective solution for dynamic abdominal wall reconstruction.
• This technique addresses limitations of previous methods, particularly in cases of severe trauma.
• The gracilis flap shows versatility and promise for improving patient outcomes in complex abdominal reconstructions.