Efficacy Evaluation Of Gracilis Musculocutaneous Flaps In The Repair Of Soft Tissue Defects Of The Limbs

Objective:To investigate the effectiveness of gracilis myocutaneous flaps in repairing soft tissue defects of limbs.Methods:A total of 26 cases of limb soft tissue defects were analyzed retrospectively from January 2017 to December 2021 using gracilis myocutaneous flap.The age ranges from 23 to 60,with an average age of 38.Soft tissue defect site: upper limb 8 cases,lower limb 18 cases.The wounds ranged from 6 cm×5 cm to 19cm×12cm.Operation time,total blood loss,complications and soft tissue repair effect were observed and recorded.Results:The applied flaps were all gracilis free myocutaneous flaps,and the flap design was divided into transverse,longitudinal and trilobal.Flap cutting range 10cm×7 cm～22 cm×15cm。The donor area is directly sutured.All patients were followed up for 12 to 36 months,with an average of 24 months.In this study,2 cases of flap vascular crisis occurred after operation,1 case of partial necrosis of flap edge,1 case of skin island necrosis,and 1 case of local cracking of donor site incision.All the other flaps survived,and the wounds in the donor and recipient areas healed at first stage.Except for 1 case of skin flap with bulky appearance and secondary repair,other skin flaps with good appearance and texture were slightly bulky.The survival rate of flap was 96.2%;At the last follow-up,the Kofoed score of ankle function in lower limb group was 73～98 points,with an average of89.7 points;13 cases were excellent,2 cases were good,and 1 case was poor.The excellent and good rate was 93.8%.Linear scar remained in the donor area,which did not adversely affect the function of lower limbs.Conclusion:The gracilis myocutaneous flap is one of the effective methods to repair the soft tissue defects of limbs,which has the advantages of large cutting range,less anatomical variation of main vascular pedicle,and concealed donor site.