The fleur-de-lis upper gracilis flap for breast reconstruction: flap design and outcome

Ann Plast Surg. 2012 Oct;69(4):383-6. doi: 10.1097/SAP.0b013e31824b25c1.

Abstract

We evaluated a fleur-de-lis design for the gracilis myocutaneous flap to improve flap volume for breast reconstruction. Thirty-one flaps were used in 17 consecutive patients undergoing the procedure for either thin body habitus (23 flaps) or prior abdominal surgery (8 flaps). The flap success rate was 100%. The fleur-de-lis flap provided proportionate breast reconstructions in all patients. Complications included 6 (19.3%) donor-site dehiscence and 4 (12.9%) episodes of cellulitis. Applying a negative pressure dressing to the donor site (n=26) significantly reduced the initially high dehiscence rate to 7.7% (P<0.01). There was no incidence of lower extremity edema or sensory loss. The fleur-de-lis gracilis flap can be performed with a low flap related complication rate and acceptable donor-site morbidity. Because of its standardized flap design, improved volume, and favorable breast shaping, it may allow autologous breast reconstruction to be offered to a greater number of patients.

Publication types

  • Clinical Trial

MeSH terms

  • Adult
  • Aged
  • Female
  • Follow-Up Studies
  • Free Tissue Flaps / transplantation*
  • Humans
  • Mammaplasty / methods*
  • Mastectomy
  • Microsurgery*
  • Middle Aged
  • Outcome Assessment, Health Care
  • Postoperative Complications / epidemiology
  • Postoperative Complications / prevention & control
  • Prospective Studies
  • Thigh