Simplifying gracilis pedicle dissection: The coronal-plane self-retractor. Technical note

Abstract

The anatomy of gracilis muscle flap pedicle and its dissection technique are well described in the literature, although dissecting its most proximal portion is technically challenging, because of the deep location and the tension in the adductor muscles posed by the harvesting position. Some modifications have been described to facilitate proximal pedicle dissection, mainly combining approaches below and above the adductor longus muscle. Throughout his experience in several hundreds of gracilis free functioning muscle transfers, the senior author has found one maneuver particularly useful in deep pedicle dissection with minimal or no need for assistance. • The gracilis muscle flap pedicle dissection technique is well described in the literature. • Dissecting its most proximal portion is technically challenging. • Some modifications combine approaches below and above the adductor longus muscle. • The senior author has found one maneuver in deep pedicle dissection with no need for assistance.