Related Experiment Video
Updated: Nov 12, 2025
The Superficial Inferior Epigastric Artery Fascia Flap for Nerve Reconstruction in Rabbits
Published on: June 13, 2025
Knee Region Coverage with Reversed Gracilis Pedicle Flap (GReSP Flap)
C Tiengo1, V Macchi2, A Porzionato2
1Section of Plastic Surgery, Department of Medical and Surgical Sciences, School of Medicine, University of Padova, Via A. Gabelli 65, 35127 Padova, Italy.
Introduction:
To treat severe soft-tissue complications of total knee arthroplasty, we used an extended reversed gracilis flap based on secondary pedicles (the GReSP flap).
Step 1 Prepare Wound Bed:
Locate the gracilis and pedicles, then debride the wound bed.
Step 2 Expose Gracilis Muscle:
Expose the superficial aspect of the muscle, while protecting the saphenous vein and nerve.
Step 3 Check Muscle Perfusion:
Temporarily clamp the main vascular pedicle to ensure blood supply when perfused only by the secondary pedicles.
Step 4 Mobilize Muscle Flap:
Transect the proximal tendon of the gracilis muscle to provide maximal length for the muscle flap and ligate the main vascular and nerve pedicles.
Step 5 Cover With Skin Graft:
Suture the flap in place and cover with skin graft.
Step 6 Postoperative Care:
Immobilize the knee for two weeks; follow with rehabilitation to restore range of motion.
Results & Preop/Postop Images:
We treated three patients who had an infection at the site of a total knee arthroplasty and exposure of the implant.
What To Watch For:
IndicationsContraindicationsPitfalls & Challenges.
