467 results match your criteria Tissue Transfer Gracilis


Dual-Vector Gracilis Muscle Transfer for Smile Reanimation with Lower Lip Depression.

Laryngoscope 2021 Mar 4. Epub 2021 Mar 4.

Department of Otolaryngology - Head and Neck Surgery, Massachusetts Eye and Ear, and Harvard Medical School, Boston, Massachusetts, U.S.A.

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Alternative flaps in autologous breast reconstruction.

Gland Surg 2021 Jan;10(1):444-459

Memorial Sloan Kettering Cancer Center, New York, NY, USA.

The gold standard for autologous reconstruction in the post-mastectomy patient remains the deep inferior epigastric artery perforator flap, although many women may not be candidates for abdominally based free tissue transfer. In this scenario, there are several other donor site options based from the thigh (transverse and diagonal upper gracilis flaps, profunda artery perforator flap, lateral thigh flap) and trunk (lumbar artery perforator flap, superior and inferior gluteal artery perforator flaps). This study will review the history, relevant anatomy, surgical technique and outcomes for alternative flaps in autologous reconstruction. Read More

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January 2021

Surgical outcome for colorectal or urinary tract-related fistula: Usefulness of vascularized tissue transfer-a retrospective study.

J Plast Reconstr Aesthet Surg 2021 05 1;74(5):1041-1049. Epub 2020 Nov 1.

Department of Colorectal Surgery, National Cancer Center Hospital East, Kashiwa, Japan.

Background: It is challenging to manage colorectal or urinary tract-related fistula. We typically treat colorectal or urinary tract-related fistula with a vascularized tissue transfer. This study aimed to analyze the outcomes of our surgical treatments for colorectal or urinary tract-related fistula. Read More

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Microsurgical Tissue Transfer in Breast Reconstruction.

Clin Plast Surg 2020 Oct;47(4):595-609

St. Andrew's Centre for Plastic Surgery & Burns, Broomfield Hospital, Court Road, Chelmsford, Essex CM1 7ET, UK.

Autologous breast reconstructions have grown in popularity because of their durability, aesthetic outcomes, symmetry, increase in external beam radiotherapy use, and potential aesthetic enhancement at the donor site. Increasing patient expectations for predictable high aesthetic outcomes with minimal complications or need for further procedures has been met by refinement in the use of flaps. The authors' microsurgical breast reconstruction center aims to provide this while delivering efficient service. Read More

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October 2020

An Update on the Management of Severe Crush Injury to the Forearm and Hand.

Clin Plast Surg 2020 Oct;47(4):461-489

Private Practice, Madrid, Spain. Electronic address:

The main goals of treating severe crush injuries are debriding away devitalized tissue and filling any resultant dead space with vascularized tissue. In the authors' experience, the most ideal methods for soft tissue coverage in treating crush injuries are the iliac flap, the adipofascial lateral arm flap, and the gracilis flap. Accompanying bone defects respond very well to free corticoperiosteal flaps. Read More

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October 2020

Arteriovenous Loops Enable Free Tissue Transfer With Otherwise Inadequate Local Donor and Recipient Vessels.

In Vivo 2020 Sep-Oct;34(5):2543-2548

Department of Plastic, Reconstructive, Aesthetic and Hand Surgery, University Hospital Basel, Basel, Switzerland.

Background/aim: Free flap reconstruction with damaged or diseased vessels is a challenging problem. We describe our case series using an arteriovenous loop or bypass surgery with free flaps for complex defect reconstructions at the lower extremity and the pelvic region.

Patients And Methods: In this single-center retrospective cohort study 11 consecutive patients (mean age=73 years, range=53-88 years) were operated on, between June 2016 and August 2018. Read More

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[Case report of frontobasal reconstruction and volume augmentation using a free gracilis muscle flap and autologous fat grafting: utilising the free flap as a scaffold for fat transplantation].

Handchir Mikrochir Plast Chir 2020 Aug 21;52(4):330-334. Epub 2020 Aug 21.

Abteilung für Hand-, Plastische und Ästhetische Chirurgie, Klinikum der Universität München, LMU München.

This case report shows the interdisciplinary treatment of a 28-year-old woman suffering from a pronounced frontal volume defect after severe craniocerebral trauma. The combination of cranioplasty using a polymethylmethacrylate (PMMA) implant, free gracilis muscle flap transfer for soft tissue coverage and serial autologous fat grafting into the muscle flap for subsequent contouring enabled both an adequate and aesthetic reconstruction. This example demonstrates the feasibility of treating increasingly complex composite defects in a multidisciplinary setting, when plastic surgeons are involved. Read More

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Composite Cutaneous Anterolateral Thigh Flap with Rolled Fascia Lata for Tibialis Anterior Tendon Reconstruction.

Plast Reconstr Surg Glob Open 2020 Jul 14;8(7):e2959. Epub 2020 Jul 14.

Department of Plastic and Reconstructive Surgery, MedStar Georgetown University Hospital, Washington, D.C.

Rupture of the tibialis anterior tendon (TAT) is a rare phenomenon with limited therapeutic options derived from sparse case reports. Without proper anchoring of the tibialis anterior, dorsiflexion and inversion of the foot become impaired, disrupting patient's gait. Reported techniques for repair fall into nonoperative (ankle-foot orthosis) or operative (primary closure, tendon transfer, free gracilis) modalities, depending on patient factors, mechanism of injury, and extent of defect. Read More

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Total aesthetic reconstruction of postburn bilateral breast loss using transverse myocutaneous gracilis free flaps: A case report and literature review.

Microsurgery 2020 Sep 4;40(6):704-709. Epub 2020 Aug 4.

University of Pittsburgh, Department of Plastic Surgery, Pittsburgh, Pennsylvania, USA.

Reconstruction of breast burns are challenging, as it includes both functional and aesthetic components. Transverse myocutaneous gracilis (TMG) flap has been used for postmastectomy breast reconstruction in the absence of abdominal donor site availability. Use of this flap for the breast burns is limited. Read More

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September 2020

Dual innervation of free gracilis muscle for facial reanimation: What we know so far.

J Plast Reconstr Aesthet Surg 2020 Dec 29;73(12):2196-2209. Epub 2020 May 29.

Division of Plastic Surgery, Department of Surgery, Mayo Clinic, 200 First Street SW, Rochester, MN 55905, US.

Background: In the last decade, some institutions have begun combining the CFNG and masseteric nerve to provide dual innervation to the gracilis muscle for dynamic facial reanimation in facial paralysis patients. We reviewed the various ways that these two nerves have been coapted to provide dual innervation, and summarized the functional outcome for these methods.

Methods: A search of the Ovid EMBASE, MEDLINE, Cochrane, and Scopus databases was performed from 1946 to May 2019 for dual innervation of gracilis muscle using CFNG plus masseteric nerve for facial reanimation. Read More

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December 2020

Restoration of Elbow Flexion With a Free Functional Gracilis Muscle Transfer in an Arthrogrypotic Patient Using a Motor Nerve to Pectoralis Major.

Hand (N Y) 2020 09 6;15(5):739-743. Epub 2020 Jun 6.

University of Southern California, Los Angeles, USA.

Patients with arthrogryposis may exhibit inability to flex the elbow. A free functional gracilis muscle transfer (FFGMT) can be used to restore elbow flexion. In our search of the available literature, we have not seen any descriptions of using a motor branch to the pectoralis major as a donor nerve to establish elbow flexion. Read More

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September 2020

Ten Years' Follow-Up after Microsurgical Reconstruction of the Lip Using Forearm Flap Combined with Gracilis Muscle Transfer.

Plast Reconstr Surg 2020 06;145(6):1115e-1117e

Department of Plastic and Reconstructive Surgery, Osaka Medical College, Takatsuki, Osaka, Japan.

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Isolated MPTL reconstruction fails to restore lateral patellar stability when compared to MPFL reconstruction.

Knee Surg Sports Traumatol Arthrosc 2021 Mar 28;29(3):793-799. Epub 2020 Apr 28.

Department of Orthopedic Surgery, Hospital for Special Surgery, New York, NY, USA.

Purpose: To biomechanically evaluate MPTL reconstruction and compare it with two techniques for MPFL reconstruction in regard to changes in patellofemoral contact pressures and restoration of patellar stability.

Methods: This is an experimental laboratory study in eight human cadaveric knees. None had patellofemoral cartilage lesions or trochlear dysplasia as evaluated by conventional radiographs and MRI examinations. Read More

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Sequential propeller flaps in the treatment of post-traumatic soft tissue defects of the lower limb - a case series.

Injury 2020 Dec 15;51(12):2922-2929. Epub 2020 Feb 15.

Depatment of Hand and Plastic Surgery, Luzerner Kantonsspital, Spitalstrasse 6000 Luzern 16, Lucerne, Switzerland. Electronic address:

Introduction: Propeller flaps have gained great popularity among reconstructive surgeons; however, the inability to directly close the donor site of large propeller flaps constitutes a well-known limitation of this technique. Skin grafting of the donor area is not always feasible nor desirable. To address large propeller flaps secondary defects, we investigated the use of a second propeller flap harvested from a nearby region of relative skin redundancy to assist the donor site closure generated by the first. Read More

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December 2020

Clinical and radiological results after one hundred fifteen MPFL reconstructions with or without tibial tubercle transfer in patients with recurrent patellar dislocation-a mean follow-up of 5.4 years.

Int Orthop 2020 02 20;44(2):301-308. Epub 2019 Dec 20.

Balgrist University Hospital, Orthopaedic Department, University of Zurich, Forchstrasse 340, CH-8008, Zurich, Switzerland.

Purpose: Medial patellofemoral ligament reconstruction (MPFLR) shows low recurrent rates and high satisfaction. Reports on outcome at mid-term follow-up in a large cohort with or without tibial tubercle transfer (TTT) are scarce.

Methods: One hundred six patients (115 knees; 24. Read More

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February 2020

Reconstruction of a large pelvic defect by transfer of a quadruplet combination of pedicled flaps from the medial thigh using bilateral muscular gracilis flaps and bilateral vertical posteromedial thigh (vPMT) propeller flaps-A case report.

Microsurgery 2020 May 5;40(4):486-491. Epub 2019 Dec 5.

Depatment of Hand- and Plastic Surgery, Luzerner Kantonsspital, Lucerne, Switzerland.

The reconstruction of defects of the perianal area and vagina places a high demand on a reconstructive surgeon. Different reconstructive methods include a skin graft, a local skin flap, a musculocutaneous flap, and a pedicled perforator flap. Here, we report the case of a 59-year-old female patient with a pelvic defect, who underwent reconstruction with a quadruplet combination of pedicled flaps from the medial thigh, due to an extensive resection of a recurrence of a squamous cell carcinoma of the anus, vulva, and partially the colon. Read More

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Foot salvage using microsurgical free muscle flaps in severely crushed foot with soft tissue defects.

Injury 2019 Dec 23;50 Suppl 5:S17-S20. Epub 2019 Oct 23.

Orthopedics and Traumatology, Hand and Microsurgery Unit, Sohag University, Sohag, Egypt. Electronic address:

Objective: Management of complex foot injuries including skin, tendons, vessels, bone, with soft tissue defects is considered as an orthopedic challenge. Microsurgical free muscle flaps provide the best solution in such cases.

Patients And Methods: Thirty two consecutive cases of complex ankle and foot injuries were treated by skin grafted muscle free flap in one stage procedure after radical debridement. Read More

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December 2019

Comparative Study of 2 Different Innervation Techniques in Facial Reanimation: Cross-face Nerve Graft-Innervated Versus Double-Innervated Free Gracilis Muscle Transfer.

Ann Plast Surg 2020 02;84(2):188-195

From the Department of Plastic and Reconstructive Surgery.

Recently, 1-stage double innervation with the masseter nerve and the cross-face nerve graft (CFNG) has gained popularity owing to its outcomes of powerful and synchronous muscle contraction. In this study, we compared CFNG- and double-innervated free gracilis muscle transfer (FGMT) for facial palsy reconstruction.A total of 49 patients with facial palsy who underwent facial reanimation surgery from August 2013 to January 2017 were enrolled. Read More

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February 2020

Clinical outcomes of chronic Achilles tendon rupture treated with flexor hallucis longus grafting and flexor hallucis longus grafting plus additional augmentation: A meta-analysis.

Foot Ankle Surg 2020 Oct 28;26(7):717-722. Epub 2019 Sep 28.

Sport and Orthopedic Center, Samitivej Hospital, Bangkok, Thailand. Electronic address:

Background: The treatment of chronic Achilles tendon rupture is still controversial. Many surgical procedures have been proposed and claim to have good post-operative clinical outcomes. These techniques include direct repair, V-Y flap, turndown flap, peroneus brevis tendon graft, flexor digitorum longus graft, FHL graft, semitendinosus graft, gracilis tendon graft or synthetic material. Read More

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October 2020

The Inverted Free Functioning Gracilis Muscle Transfer For Restoration of Elbow Flexion Following Delayed Presentation or Failed Primary Nerve Reconstruction of Upper Trunk Injuries.

Tech Hand Up Extrem Surg 2020 Mar;24(1):26-31

Department of Surgery, Division of Plastic and Reconstructive Surgery.

Free functional gracilis transfer is a well-established technique for restoring active elbow flexion in brachial plexus injuries following delayed presentation or failed nerve reconstruction procedures. In cases of delayed presentation or failed nerve reconstruction following upper trunk injuries, the lower trunk intraplexal median and ulnar nerves are spared, thereby making them available to reinnervate the transferred gracilis. Therefore, we have inverted the conventional free functional gracilis orientation so as to orient the flap's recipient nerve in closer proximity to donor median or ulnar nerve fascicles to enable a short, tension-free coaptation in the middle to distal arm. Read More

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Extensive Microsurgical Reconstruction of Chest Wall Defects for Locally Advanced Breast Cancer: A 10-Year Single-Unit Experience.

Ann Plast Surg 2020 03;84(3):293-299

From the Department of Oncology Plastic Surgery, Hunan Province Cancer Hospital and The Affiliated Cancer Hospital of Xiangya School of Medicine, Central South University, Changsha, Hunan.

Background: Despite improvements in the early detection of breast cancer, locally advanced breast cancer (LABC) involving the chest wall exists in developing countries. Surgical resection remains a controversial management option. This study aims to demonstrate the value of chest wall reconstructive techniques for large LABC defects and report long-term outcomes. Read More

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Effectiveness and safety of the use of gracilis muscle for dynamic smile restoration in facial paralysis: A systematic review and meta-analysis.

J Plast Reconstr Aesthet Surg 2019 Aug 24;72(8):1254-1264. Epub 2019 May 24.

Division of Plastic and Reconstructive Surgery, Department of Surgery, University of Toronto, Toronto, ON, Canada; Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, ON, Canada. Electronic address:

Background: Smiling is a fundamental component of social interactions. Significant challenges arise for patients with facial palsy. One of the key procedures for dynamic smile restoration is the microneurovascular transfer of a gracilis muscle. Read More

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Combined delivery of VEGF and IGF-1 promotes functional innervation in mice and improves muscle transplantation in rabbits.

Biomaterials 2019 09 7;216:119246. Epub 2019 Jun 7.

John A. Paulson School of Engineering and Applied Sciences, Harvard University, Cambridge, MA 02138, USA; Wyss Institute for Biologically Inspired Engineering at Harvard University, Cambridge,MA 02138, USA. Electronic address:

Microvascular muscle transfer is the gold standard for reanimation following chronic facial nerve paralysis, however, despite the regenerative capacity of peripheral motor axons, poor reinnervation often results in sub-optimal function. We hypothesized that injection of alginate hydrogels releasing growth factors directly into donor tissue would promote reinnervation, muscle regeneration, and function. A murine model of sciatic nerve ligation and neurorrhaphy was first used to assess the ability of gel delivery of vascular endothelial growth factor (VEGF) and insulin-like growth factor-1 (IGF-1) to promote functional reinnervation. Read More

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September 2019

Porcine experimental model for gracilis free flap transfer to the head and neck area with novel donor site description.

J Plast Reconstr Aesthet Surg 2020 Jan 22;73(1):111-117. Epub 2019 May 22.

Head and Neck Surgery and Reconstructive Surgery Section of the Oto-rhino-laryngology Department, Hospital Universitario Donostia-Donostia Unibersitate Ospitalea, P° Dr. Begiristain 109, 20004 Donostia San Sebastián, Gipuzkoa, Spain.

Introduction: Functional free tissue transfer in the form of muscle free flap is a challenging surgical procedure and needs a steep learning curve. A porcine model for free muscle transfer and insetting in a distant area is of great interest in reconstructive microsurgery due to the experience and learning curve necessary to perform these surgeries. The aim of this study was to assess the feasibility of a swine model for gracilis muscle free transfer and to describe the donor site anatomy. Read More

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January 2020

[Primary revision with replasty of the anterior cruciate ligament].

Oper Orthop Traumatol 2019 Jun 6;31(3):221-247. Epub 2019 Jun 6.

Klinik für Orthopädie und Unfallchirurgie, Martin Luther Krankenhaus, Caspar Theysstraße 27-31, 14193, Berlin, Deutschland.

Objective: Restoration of knee stability after rerupture of an anterior cruciate ligament (ACL) graft.

Indication: Acute and chronic functional instability with rerupture of an ACL graft with subjective instability with anatomical or non-anatomical bone tunnel without tunnel widening.

Contraindications: Partial anatomical bone tunnels of the previous operation, significant tunnel widening of anatomical bone tunnels, local infection of the knee joint, local soft tissue damage. Read More

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Late avulsion of a free flap in a patient with severe psychiatric illness: Establishing a successful salvage strategy.

Arch Plast Surg 2019 Apr 20:589-593. Epub 2019 Apr 20.

Department of Plastic, Reconstructive and Hand Surgery, University Hospital of Lausanne (CHUV), Lausanne, Switzerland.

Post-traumatic defects of the distal third of the leg often require skipping a few steps of the well-established reconstructive ladder, due to the limited local reliable reconstructive options. In rare cases, the reconstructive plan and flap choice may encounter challenges when the patient has psychiatric illness affecting compliance with postoperative care. We describe a case of a patient with severe intellectual disability and an open fracture of the distal lower limb. Read More

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Facial reanimation with masseter nerve-innervated free gracilis muscle transfer in established facial palsy patients.

Arch Plast Surg 2019 Mar 31;46(2):122-128. Epub 2019 Mar 31.

Department of Plastic Surgery, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea.

Background: The masseter nerve is a useful donor nerve for reconstruction in patients with established facial palsy, with numerous advantages including low morbidity, a strong motor impulse, high reliability, and fast reinnervation. In this study, we assessed the.

Results: of masseter nerve-innervated free gracilis muscle transfer in established facial palsy patients. Read More

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Microsurgical Reconstruction of the Lower Extremity.

Semin Plast Surg 2019 Feb 8;33(1):54-58. Epub 2019 Mar 8.

Division of Plastic Surgery, Baylor College of Medicine, Houston, Texas.

Reconstruction of bony and soft tissue defects of the lower extremity has been revolutionized by the advent of microsurgical tissue transfer. There are numerous options for reconstruction. Possibilities include transfer of soft tissue, composite (bone and soft tissue) tissue, and functional muscle. Read More

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February 2019

Free Tissue Transfer for Upper Extremity Reconstruction.

Semin Plast Surg 2019 Feb 8;33(1):17-23. Epub 2019 Mar 8.

Division of Plastic Surgery, Baylor College of Medicine, Houston, Texas.

With the advent of the Industrial Revolution, traumatic injuries of the upper extremity increased exponentially. As a result, surgeons began to reevaluate amputation as the standard of care. Following the Second World War, local and regional pedicled flaps became common forms of traumatic upper extremity reconstruction. Read More

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February 2019