486 results match your criteria Tissue Transfer Gracilis


Free Functional Muscle Transfer following Upper Extremity Sarcoma Resection: A Case Report.

Plast Reconstr Surg Glob Open 2022 Jun 10;10(6):e4367. Epub 2022 Jun 10.

Department of Surgery, Division of Plastics and Reconstructive Surgery, The Ottawa Hospital, Ontario, Ottawa, Canada.

Functional reconstruction of the upper extremity has traditionally involved tendon transfer or pedicled muscle transfer. The gracilis free functional muscle transfer remains as an excellent option for restoration of finger flexion. Here, we provide a case report of a 35-year-old man diagnosed with left forearm high-grade epithelioid sarcoma who underwent innervated free gracilis transfer and a secondary free flap, the profunda artery perforator flap, through a single donor-site incision to expand soft tissue coverage. Read More

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Functional Outcome Comparison of Free Gracilis Muscle Anchoring Methods in Patients with Facial Paralysis: Upper Lip Red Line Incision versus Facelift Incision Approach.

J Reconstr Microsurg 2022 Apr 14. Epub 2022 Apr 14.

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

Background:  The greatest challenge of a free-muscle transfer in facial reanimation surgery is anchoring muscle to perioral soft tissue. An additional incision provides a better way to anchor the transferred muscle but leaves a visible scar. Herein, we compared the functional and aesthetic outcomes in a conventional facelift incision approach with and without the addition of a red line incision. Read More

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Procedures for obtaining muscle physiology parameters during a gracilis free-functioning muscle transfer in adult patients with brachial plexus injury.

Sci Rep 2022 04 12;12(1):6095. Epub 2022 Apr 12.

Department of Orthopedic Surgery, Mayo Clinic, Rochester, MN, USA.

A complete understanding of muscle mechanics allows for the creation of models that closely mimic human muscle function so they can be used to study human locomotion and evaluate surgical intervention. This includes knowledge of muscle-tendon parameters required for accurate prediction of muscle forces. However, few studies report experimental data obtained directly from whole human muscle due to the invasive nature of these experiments. Read More

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Success of Implantable Doppler Probes for Monitoring Buried Free Flaps.

Otolaryngol Head Neck Surg 2022 Feb 22:1945998221082533. Epub 2022 Feb 22.

Division of Otolaryngology-Head and Neck Surgery, Department of Surgery, University of Utah Hospital, Salt Lake City, Utah, USA.

Objective: The objective of this study is to describe the operative success of completely buried free flaps and to determine the safety/reliability of using implantable dopplers for postoperative monitoring in completely buried free flaps.

Study Design: A retrospective chart review was conducted from 2014 to 2020. Patients were included who had implantable dopplers placed for monitoring a completely buried free flap without a visible skin paddle. Read More

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February 2022

A case report of upper limb loss of substance: Use of functional gracilis free flap, brachioradialis transposition and bioglass for bone regeneration.

Trauma Case Rep 2022 Apr 31;38:100609. Epub 2022 Jan 31.

Department of Reconstructive and Hand Surgery, AOU "Ospedali Riuniti", 60126 Ancona, Italy.

Complex trauma of the upper limb is a common consequence of involvement in serious accidents. Loss of substance including nerve, bone, tendons and vascular defects are challenging surgical issues. A 27- year-old male presented with complex upper limb trauma and loss of a proximal third of the posterior forearm structure as well as loss of active finger extension, ulnar and radial nerve territory anesthesia and ulnar fracture. Read More

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Free functional muscle transfer for upper limb paralysis - A systematic review.

J Plast Reconstr Aesthet Surg 2022 03 23;75(3):1001-1017. Epub 2021 Oct 23.

Stoke Mandeville Hospital, Buckinghamshire Healthcare NHS Trust, UK; Nuffield Department of Orthopaedics, Rheumatology, and Musculoskeletal Sciences, University of Oxford, UK.

Background: Functional restoration of upper limb paralysis represents a major reconstructive challenge. Free functional muscle transfer (FFMT) enables reanimation in patients with a lack of local donor tissues or delayed presentation. This systematic review summarises the evidence for FFMT in the reconstruction of upper limb paralysis. Read More

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Free gracilis end-to-side microanastomosis to a peronea arteria magna: a case report.

J Med Case Rep 2021 Dec 13;15(1):601. Epub 2021 Dec 13.

Department of Plastic Surgery, Hull University Teaching Hospitals NHS Trust, Hull, UK.

Background: Complex orthoplastic lower limb trauma in individuals with multiple injuries requires considerable resources and interdisciplinary collaboration for good outcomes. We present the first reported end-to-side free flap microanastomosis for lower limb trauma reconstruction involving a peronea arteria magna without radiographic collaterals.

Case Presentation: A 55-year-old Caucasian gentleman involved in road traffic collision sustained an open tibial fracture on the anteromedial distal third of the left lower leg with local degloving and a subtotal right foot and ankle degloving. Read More

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December 2021

Single-Port Robotic Posterior Urethroplasty Using Buccal Mucosa Grafts: Technique and Outcomes.

Urology 2022 01 6;159:214-221. Epub 2021 Oct 6.

Department of Urology, Grossman School of Medicine at New York University Langone Health, New York, NY. Electronic address:

Objective: To describe the technique, feasibility and short-term outcomes of buccal mucosa grafts in robotic lower urinary tract reconstruction.

Methods: We reviewed 9 patients who underwent single-port robotic posterior urethroplasty with buccal mucosa graft from May-December 2019. Variables included patient demographics, diagnosis/etiology, and intraoperative parameters. Read More

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January 2022

Lessons Learned from 30 Years of Transverse Myocutaneous Gracilis Flap Breast Reconstruction: Historical Appraisal and Review of the Present Literature and 300 Cases.

J Clin Med 2021 Aug 17;10(16). Epub 2021 Aug 17.

Department of Plastic and Reconstructive Surgery, Marienhospital Stuttgart, Teaching Hospital of the Eberhard Karls University, 72074 Tübingen, Germany.

Background: Happy 30th birthday to the transverse myocutaneous gracilis (TMG) flap. Since 1991 the TMG flap has been used to reconstruct a wide variety of defects and became a workhorse flap and reliable alternative to the deep inferior epigastric perforator (DIEP) flap in many breast reconstruction services worldwide. This manuscript sheds light on the history and success of the TMG flap by critically reviewing the present literature and a series of 300 patients receiving a breast reconstruction. Read More

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In vivo human gracilis whole-muscle passive stress-sarcomere strain relationship.

J Exp Biol 2021 09 3;224(17). Epub 2021 Sep 3.

Shirley Ryan AbilityLab, Chicago, IL 60611, USA.

We measured the passive mechanical properties of intact, living human gracilis muscles (n=11 individuals, 10 male and 1 female, age: 33±12 years, mass: 89±23 kg, height: 177±8 cm). Measurements were performed in patients undergoing surgery for free-functioning myocutaneous tissue transfer of the gracilis muscle to restore elbow flexion after brachial plexus injury. Whole-muscle force of the gracilis tendon was measured in four joint configurations (JC1-JC4) with a buckle force transducer placed at the distal tendon. Read More

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September 2021

Simple, but effective: Nasal splinting for airway securement in free flap reconstruction following orbital exenteration.

Head Neck 2021 10 15;43(10):3238-3244. Epub 2021 Jul 15.

Department of Plastic, Reconstructive and Aesthetic Surgery, Medical University of Innsbruck, Innsbruck, Austria.

Orbital exenteration is a disfiguring procedure that often results in free tissue transfer for reconstructive purposes. The reconstructive focus is the obliteration of dead space while sparing the nasal airway, particularly if the medial orbital wall was resected. Prolapse of transferred tissue into the nasal airway may cause breathing difficulties drastically compromising quality of life. Read More

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October 2021

Lessons from Gracilis Free Tissue Transfer for Facial Paralysis: Now versus 10 Years Ago.

Facial Plast Surg Clin North Am 2021 Aug;29(3):415-422

Division of Facial Plastic and Reconstructive Surgery, Department of Otolaryngology, Massachusetts Eye and Ear Infirmary, Harvard Medical School, 243 Charles Street, Boston, MA, USA.

Outcomes following free gracilis muscle transfer have steadily improved during the past decade. Areas for continued improvement include re-creating natural smile vectors, improving midface symmetry, minimizing scarring, improving spontaneity, and increasing reliability using various neural sources. Outcome standardization, pooled data collection, and remote data acquisition methods will facilitate comparative effectiveness research and continued surgical advancements. Read More

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Temporalis Tendon Transfer Versus Gracilis Free Muscle Transfer: When and Why?

Facial Plast Surg Clin North Am 2021 Aug;29(3):383-388

Head and Neck Institute, Cleveland Clinic Foundation, 9500 Euclid Avenue A71, Cleveland, OH 44106, USA.

Temporalis tendon transfer (T3) and gracilis free muscle transfer (GFMT) are popular techniques in lower facial rehabilitation when reinnervation techniques are unavailable. T3 involves a single-stage outpatient procedure resulting in immediate improvement in resting symmetry and a volitional smile. GFMT allows a spontaneous smile, customized vectors, and increased excursion but requires longer surgical time, a delay before movement, and specialized equipment. Read More

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Adductor magnus muscle transfer to restore knee extension: Anatomical studies and clinical applications.

J Plast Reconstr Aesthet Surg 2021 Nov 8;74(11):2925-2932. Epub 2021 Apr 8.

Division of Plastic Surgery, Department of Surgery, Washington University School of Medicine, 660 South Euclid Avenue, Campus Box 8238, St. Louis, MO, USA. Electronic address:

Background: Loss of knee extension causes significant impairment. Though nerve-based reconstruction is preferable in cases of femoral nerve palsy or injury, these surgeries are not always appropriate if the pathology involves the quadriceps muscles or presentation too late for muscle reinnervation. Muscle transfers are another option that has been underutilized in the lower extremity. Read More

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November 2021

Percutaneous Reconstruction of the Medial Patello-Femoral Ligament Using Dynamic Gracilis Tendon Transfer.

Orthop Traumatol Surg Res 2021 06 31;107(4):102910. Epub 2021 Mar 31.

Service de chirurgie orthopédique et traumatologique, Centre Hospitalo-Universitaire Tours - Université de Médecine de Tours François Rabelais, 37000 Tours, France.

Background: Many techniques have been described for reconstructing the medial patello-femoral ligament (MPFL), using a variety of transplants and fixation methods to treat patello-femoral dislocation. The main challenge with static transfers is to position the femoral fixation point at the site that best restores MPFL anisometry. The objective of this cadaveric study was to propose a version of the initially described dynamic gracilis transfer technique that can be performed percutaneously. Read More

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

Laryngoscope 2021 08 4;131(8):1758-1760. 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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Workhorse Free Functional Muscle Transfer Techniques for Smile Reanimation in Children with Congenital Facial Palsy: Case Report and Systematic Review of the Literature.

J Plast Reconstr Aesthet Surg 2021 07 31;74(7):1423-1435. Epub 2021 Jan 31.

Department of Plastic and Reconstructive Surgery, Great Ormond Street Hospital for Children, NHS Foundation Trust, London, United Kingdom; Department of Plastic and Hand Surgery; Inselspital, Bern University Hospital, Bern, Switzerland; Professor at University College of London, Division of Surgery and Interventional Science, London, United Kingdom.

Background: Pediatric facial palsy represents a rare multifactorial entity. Facial reanimation restores smiling, thus boosting self-confidence and social integration of the affected children. The purpose of this paper is to present a systematic review of microsurgical workhorse free functional muscle transfer procedures with emphasis on the long-term functional, aesthetic, and psychosocial outcomes. Read More

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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

Dynamic Hemitongue Defect Reconstruction With Functional Gracilis Muscle Free Transfer.

Ann Plast Surg 2021 03;86(3):308-316

From the Department of Plastic and Reconstructive Surgery, University of Ulsan, College of Medicine, Seoul Asan Medical Center, Seoul, Korea.

Background: Because the tongue consists of 26 intrinsic and extrinsic muscles, even hemiglossectomy, which preserves some of the tongue and its muscles, leads to functional morbidity in speech and swallowing. Subsequent reconstruction using a conventional fasciocutaneous flap results in limited functional recovery. This study compared the functional recovery of patients who underwent hemiglossectomy based on the fasciocutaneous free flap with or without dynamic gracilis muscle flap reconstruction. Read More

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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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Combined medial patellofemoral and medial patellotibial reconstruction for patellar instability: a PRISMA systematic review.

J Orthop Surg Res 2020 Nov 12;15(1):529. Epub 2020 Nov 12.

Department of Musculoskeletal Disorders, Faculty of Medicine and Surgery, University of Salerno, 84084, Baronissi, Italy.

Background: The medial patellofemoral ligament (MPFL) works in association with the medial patellotibial ligament (MPTL) and the medial patellomeniscal ligament (MPML) to impart stability to the patellofemoral joint. The anatomy and biomechanical characteristics of the MPFL have been well described but little is known about the MPTL and MPML. Several reconstruction procedures of the MPFL with semitendinosus, gracilis, patellar and quadriceps tendons, allografts and synthetic grafts have been described. Read More

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November 2020

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