Évaluation des séquelles du site donneur du lambeau libre de muscle gracilis. À propos de 32 cas Donor site morbidity after free gracilis muscle flap. Report of 32 cases

SummaryBackground. — Coverageoftissuedefectsofthelowerlimbsisacomplexproblem.Freegracilismuscle flap is a reliable surgical technique and the morbidity of its donor site is considered as Ourretrospective study involved all patients who underwent afree gracilis muscle flap a reconstructive surgery of thelower limb.To best our knowledge,thisis firststudy assess comprehensively theaesthetic and functional morbidity of free gracilis flap donorPatients andmethods. — Thirty-twopatientsunderwentagracilismusclefreeflapinourplasticsurgery department,betweenJanuary2009andApril2012,aspartofareconstructivesurgeryofthe lower limb. All medical datas were carried out using computerized records. Aesthetic andfunctional assessments of the donor site were done by the patient using questionnaires and by aplastic surgeon and a physiotherapist using a clinical evaluation, 6 months after surgery. Acomparative studybetweenbothlimbsincludingthethighperimeteranalysis,anisokineticstudyof theknee,astudy oftherangeofmotion ofhipandknee,andanassessment ofthestrengthofadduction of the hip were conducted.Results. — Concerning the aesthetic outcomes, the clinical and subjective scores were satis-factory with a Vancouver score under 1. Five patients had a decrease in the volume of the thighafter surgery. Concerning the functional outcomes, no motor or sensory defects were reported.No statistically significant difference was demonstrated for the range of motion of the hip andknee between both limbs. The strength of hip adduction was not altered by the removal of thegracilis muscle.Conclusion. — This study confirms the low aesthetic and functional donor site morbidity of thefree gracilis muscle flap. The aftermath of the donor area of the flap are very well accepted bypatients, which is a sign of good acceptance of the whole reconstruction. Because of thesefindings andthesuitabilityoftheflapattherecipientsite,thegracilismusclefreeflapshouldbepart of the armamentarium of any reconstructive surgeon.# 2013 Elsevier Masson SAS. All rights reserved.