A new alternative in burn reconstruction: the muscle vascularized pedicle flap

A technique is presented that revascularizes a portion of skin and subcutaneous tissue by the implantation of a vascular pedicle surrounded by a small amount of muscle. The muscle vascularized pedicle flap technique allows one to select a skin territory and convert it into a free flap donor site as long as it is within the arc of rotation of a major vascular pedicle. The vascular pedicle and small portion of muscle is simply sutured to a sequentially delayed skin flap. After approximately two or three weeks the newly revascularized skin and subcutaneous tissue is transferred as a conventional free flap. The main advantage is that of freeing the reconstructive surgeon from the anatomical landmarks of the conventional free flap areas. In addition, one can fashion a very thin flap to fit the defect exactly. Illustrative cases are presented.