The Rectus Femoris Flap for Groin Reconstruction

Operative Plastic Surgery ◽

10.1093/med/9780190499075.003.0079 ◽

2019 ◽

pp. 817-822

Author(s):

Peter C. Neligan

Keyword(s):

Vastus Lateralis ◽

Muscle Flap ◽

Knee Extensor ◽

Rectus Femoris ◽

Pedicled Flap ◽

Skin Paddle ◽

Rectus Femoris Muscle ◽

Alt Flap ◽

Femoris Muscle ◽

Lower Abdominal Wall

The rectus femoris muscle is an important but expendable knee extensor. It is a bipennate muscle with a dense and strong fascia on its undersurface. This feature makes it extremely attractive for the repair of defects of the lower abdominal wall and groin as a pedicled flap. It is centrally located between the vastus medialis and vastus lateralis muscles. It is generally used as a pedicled muscle and usually taken as a muscle flap without a skin paddle. The muscle is then grafted. Following harvest, the extensor tendons need to be centralized and repaired for a distance of 6–8 cm above the knee. In many situations this flap has been superseded by the ALT flap.

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One plus one: Two free flaps from same donor thigh for simultaneous coverage of two different defects

Indian Journal of Plastic Surgery ◽

10.4103/0970-0358.191325 ◽

2016 ◽

Vol 49 (02) ◽

pp. 191-197

Author(s):

Susmitha Bandi ◽

Rayidi Venkata Koteswara Rao ◽

Damalacheruvu Mukunda Reddy

Keyword(s):

Femoral Artery ◽

Lower Limb ◽

Muscle Flap ◽

Rectus Femoris ◽

Free Flaps ◽

Limb Defects ◽

Circumflex Femoral Artery ◽

Rectus Femoris Muscle ◽

Alt Flap ◽

Femoris Muscle

ABSTRACT Introduction: Primary microvascular reconstruction of multiple defects is challenging particularly if it has to be simultaneous. In trauma cases, harvesting two independent free flaps from different sites is very time-consuming and adds to morbidity. To eliminate these disadvantages, we sought to find out a reliable alternative method of harvesting two independent free flaps based on the descending branch of circumflex femoral artery, i.e., one anterolateral thigh (ALT) flap and one rectus femoris muscle flap. Aim: To study the feasibility of transferring two free flaps, i.e., ALT and rectus femoris muscle flap simultaneously from the same thigh for coverage of two different limb defects. Materials and Methods: From 2003 to 2012, five patients with two defects each were managed with a total of ten flaps harvested from five donor sites based on independent pedicles of descending branch of lateral circumflex femoral artery and used to cover severe injuries of extremities. Three cases had both lower limb defects and two cases had one upper limb and one lower limb defect. In each case, one ALT flap and one rectus femoris muscle flap were used for coverage. Results: All reconstructive procedures were completed without any major complications. All flaps survived well. There were no re-explorations and no complications related to donor sites. Conclusion: We conclude that our approach of simultaneous harvest of ALT and rectus femoris muscle from the same thigh offers two flaps for two different defects in terms of economy of donor site and operating time.

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