Application of free transverse upper gracilis flap in breast reconstruction

Dajiang SONG; Zan LI; Xiao ZHOU; Yixin ZHANG; Xiaowei PENG; Bo ZHOU; Chunliu LYU; Cuie PENG; Wen PENG; Huangxing MAO; Hui LI; Zeyang LIU

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Application of free transverse upper gracilis flap in breast reconstruction

VernacularTitle: 游离横行股薄肌肌皮瓣在乳房重建的应用
Author: Dajiang SONG ¹ ; Zan LI ¹ ; Xiao ZHOU ¹ ; Yixin ZHANG ² ; Xiaowei PENG ¹ ; Bo ZHOU ¹ ; Chunliu LYU ¹ ; Cuie PENG ¹ ; Wen PENG ¹ ; Huangxing MAO ¹ ; Hui LI ¹ ; Zeyang LIU ¹
Author Information

1. Department of Oncology Plastic Surgery, Hunan Province Cancer Hospital and Affiliated Cancer Hospital of Xiangya School of Medicine, Central South University, Changsha 410008, China
2. Department of Plastic and Reconstructive Surgery, Shanghai Ninth People′s Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 20011, China
Publication Type:Journal Article
Keywords: Breast cancer; Gracilis myocutaneous flap; Breast reconstruction; Free flap
From: Chinese Journal of Plastic Surgery 2019;35(3):237-242
CountryChina
Language:Chinese
Abstract: Objective:To explore the clinical application of the transverse upper gracilis flap (TUG) in breast reconstruction for breast cancer patients.
Methods:From March 2010 to September 2016, 15 breast cancer patients received radical or modified radical mastectomy in Hunan Cancer Hospital, 8 cases of breast cancer were in stage Ⅰ and 7 cases was in stage Ⅱ. The age of patients ranged from 37 to 62 years old, (39.5±4.7) years. The TUG flap was used to reconstruct breast at the same time.The donor leg is placed in frog-leg position. Free TUG flap was harvested with gracilis muscular branch of profunda artery as pedicle. To keep tight connection between skin paddle and gracilis muscle, the perforators are not visualized. The flap was transferred to reconstruct breast, and the donor site was directly closed.
Results:Mean operative time of unilateral reconstruction was 5 hours and (35± 44) minutes (with the range from 4 hours and 17 minutes to 6 hours and 5 minutes). Mean ischemia time was (52± 9 )minutes (with the range from 40 minutes to 1 hour and 16 minutes). The length of flap was (27.1±0.1) cm. The width of flap was (7.8±0.5) cm. The thickness of flap was (3.4±0.2) cm. The length of pedicle was( 6.8±0.5) cm.The average weight of flap was 350 g (ranged from 285 g to 525 g). All TUG flaps were survived. The shape, texture and elasticity of all reconstructed breasts were satisfactory, and there is no flap contracture deformation happened. Only linear scar left in the donor sites, without sacrifice of the function of thighs. All 15 patients were followed for 9-36 months (16.5 months on average). No local recurrence happened.
Conclusion:TUG flap can be safely harvested. It is reliable, with good texture. It is an alternative method for breast reconstruction after radical or modified radical mastectomy.