Anatomy of the proximal cutaneous perforator vessels of the gracilis muscle

Kappler, U.A.; Constantinescu, Mihai A.; Büchler, U; Vögelin, Esther

doi:10.1016/j.bjps.2004.11.021

Cited by 37 publications

(27 citation statements)

References 14 publications

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“…This method is very accurate and informative (Macchi et al, 2005b), and the course and the caliber of the artery of each vascular pedicle can be determined in detail. It does not, however, determine the position of perforator arteries, which provide the blood supply to the skin overlying the muscle and are important in harvesting both musculocutaneous and perforator flaps (Whetzel and Lechtman, 1997;Hallock, 2003;Tiengo et al, 2004Tiengo et al, , 2007Kappler et al, 2005;Lykoudis et al, 2005). If such an operation is planned, CT angiography should be complementary to transcutaneous Doppler studies.…”

Section: Discussionmentioning

confidence: 96%

The gracilis muscle and its use in clinical reconstruction: An anatomical, embryological, and radiological study

et al. 2008

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The gracilis muscle is used widely in reconstructive surgery, as a pedicled or as a free microsurgical flap, for soft tissue coverage or as a functioning muscle transfer. Many studies, based on cadaver dissections, have focused on the vascular anatomy of the gracilis muscle and provided different data about the number, origin, and caliber of its vascular pedicles. Computed tomographic (CT) angiography of both thighs of 40 patients (35 males and 5 females, mean age: 63 years) have been analyzed to provide a detailed anatomical description of the arterial supply of the gracilis muscle. The gracilis muscle had a mean length of 41 +/- 2.1 cm. The principal pedicle enters the gracilis muscle at a mean distance (+/-SD) of 10 +/- 1 cm from the ischiopubic attachment of the muscle. Its caliber shows a mean value of 2.5 +/- 0.5 mm, and it is statistically larger when originating directly from the deep femoral artery (45%) than from its muscular branch supplying the adductors, i.e., the "artery to the adductors" (46%) (P < 0.01). A significant correlation between the caliber of the artery of the main pedicle and the volume of the gracilis muscle was found (P < 0.01). The mean number of distal accessory pedicles is 1.8 (range, 1-4,) and the artery of the first of these pedicles shows a mean caliber of 2.0 mm. There is no correlation between either the number or the caliber of the artery of the accessory pedicles and the volume of the gracilis muscle. CT angiography, providing detailed images of the muscular and vascular structures of the thigh of each patient, could be a useful preoperative study for the reconstructive surgeon. It would allow a personalized planning of a gracilis flap, reducing the risk of iatrogenic damage.

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Section: Discussionmentioning

confidence: 96%

The gracilis muscle and its use in clinical reconstruction: An anatomical, embryological, and radiological study

et al. 2008

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“…Cadaver dissection from 23 thighs reveals the dominant pedicle reliably enters the muscle in the region of 10 cm below the pubic tubercle 10. Hussey et al 11 have shown the mean entry point of the dominant pedicle is 9.4 cm from the origin of the muscle, with a mean length of 38.4 cm and a width of 6.2 cm.…”

Section: Discussionmentioning

confidence: 99%

Saving grace: distally pedicled gracilis muscular flap in lower limb salvage

et al. 2014

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During the 1970s, the incidence of limb amputation following surgery for sarcoma excision was as high as 50%. Two important developments have led to modern day limb salvage, namely chemotherapy and precision imaging techniques. We present a case of limb salvage in a patient with osteosarcoma plagued with recurrent infection after prosthetic revision. We discuss the use of the distally based pedicled gracilis muscular flap, which has little mention as a reconstructive option for defects around the knee.

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“…This "mother" vessel enters the undersurface of the gracilis muscle at about 6 -12 cm below the pubic tubercle. 14,15 As enumerated in many other anatomic dissections, 1-4 significant musculocutaneous perforators can be found emanating through the proximal gracilis muscle within a region approximately 3 cm in radius centered over its vascular hilum. 14 -16 Septocutaneous perforators can also be present, arising through the septum medial to the adductor longus muscle.…”

Section: Surgical Anatomymentioning

confidence: 99%

Scrotal Reconstruction Following Fournier Gangrene Using the Medial Circumflex Femoral Artery Perforator Flap

Hallock

2006

Annals of Plastic Surgery

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Fournier gangrene can have devastating consequences. Often in the male, the testicles become exposed and demand both a functional and esthetic coverage. Local medial thigh cutaneous flaps usually still are available and have evolved to become a preferred solution. The medial circumflex femoral artery perforator (MCFAP) flap based on musculocutaneous perforators of the gracilis muscle represents yet another one of these options. As with all muscle perforator flaps, no muscle need be expended. A case report illustrates the role of the MCFAP flap for creation of a neoscrotum.

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Anatomy of the proximal cutaneous perforator vessels of the gracilis muscle

Cited by 37 publications

References 14 publications

The gracilis muscle and its use in clinical reconstruction: An anatomical, embryological, and radiological study

The gracilis muscle and its use in clinical reconstruction: An anatomical, embryological, and radiological study

Saving grace: distally pedicled gracilis muscular flap in lower limb salvage

Scrotal Reconstruction Following Fournier Gangrene Using the Medial Circumflex Femoral Artery Perforator Flap

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