Further Experience with the Medial Circumflex FemoralGRACILISPerforator Free Flap

The microsurgical transfer of the medial groin skin territory previously required this to be part of a transverse-oriented gracilis musculocutaneous free flap. As the concept of muscle perforator flaps has evolved, avoidance of muscle bulk and/or retention of muscle function here is also possible with the careful intramuscular dissection of the gracilis musculocutaneous perforators back to the usual medial circumflex femoral source vessel. This so-called medial circumflex femoral (GRACILIS) [MCF (GRACILIS)] perforator free flap has been successfully used seven times in six patients with minimal complications. The MCF (GRACILIS) muscle perforator flap may well represent the ideal skin flap: no muscle function is sacrificed; a reliable skin territory of large size is available; the dominant vascular pedicle is consistent in location; the flap may be harvested with the patient in a supine position; a combined conjoint flap including the gracilis muscle is optional; closure of the donor site leaves a medial groin scar that can be readily concealed; and flap dissection in this region is already very familiar to most microsurgeons.