The Medial Circumflex FemoralGRACILIS Local Perforator Flap–A Local Medial Groin Perforator Flap

In Brief The medial circumflex femoralGRACILIS perforator free flap has been previously used to capture the superior medial thigh skin territory. This can also be valuable as a local flap, especially for adjacent groin wounds that are not uncommon after vascular interventions. Uncomplicated healing without vascular compromise was achieved using this as a local flap in 4 recent cases. Because the gracilis muscular branches can be independently dissected from the musculocutaneous perforators, the muscle itself can be separately included to form a combined conjoint flap, where the muscle is specifically only used to wrap around and protect any exposed vascular structures while the cutaneous component simplifies skin wound closure. The axis of rotation of the medial circumflex femoral perforator local flap extends throughout the groin region and potentially to the lateral thigh. This is an ideal local perforator flap because the source pedicle has a consistent location already well known to most plastic surgeons, the boundaries of the potential skin territory are reliable and well defined, and the scar from closure of the donor site within the medial groin can be readily concealed by clothing. The superomedial thigh skin was found to be transferable as a free flap based solely on the musculocutaneous perforator(s) arising from the gracilis muscle. The flap has the advantages of reliability, concealability of the scar, a consistent vascular pedicle, and no requirement for muscle inclusion.