The conjoint medial circumflex femoral perforator and gracilis muscle free flap

The conjoint medial circumflex femoral perforator-gracilis muscle free flap can simultaneously incorporate the superomedial thigh skin territory and the underlying gracilis muscle. Gracilis musculocutaneous branches that sustain the perforator flap can be independently dissected from discrete muscle branches. Although the branches originate from the same dominant source pedicle to the gracilis muscle, this maneuver allows the separate insetting of each component as desired. This combination flap has been successfully used for wound coverage in four clinical cases, with only minor difficulties. Because of a favorable anatomical anomaly, in one case the perforator flap and corresponding muscle flap could be transferred to different extremities from a single donor site. This perforator flap could be considered an ideal skin flap, because the defined skin territory is reliable, harvesting can be performed with the patient supine, the vascular pedicle has a consistent location well known to plastic surgeons, and any donor-site scars in the medial groin can be readily concealed.