Journal of reconstructive microsurgery
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J Reconstr Microsurg · Oct 2006
Free inferior gluteal flap harvest with sparing of the posterior femoral cutaneous nerve.
The free inferior gluteal flap is a major secondary choice of autologous tissue for breast reconstruction if the TRAM flap is not an option. Loss of posterior thigh and popliteal sensibility is a frequent sequela of harvesting the free inferior gluteal musculocutaneous flap and the inferior gluteal artery perforator (I-GAP) flap. The posterior femoral cutaneous nerve of the thigh lies directly on the deep surface of the gluteus maximus muscle, having a very close anatomic relationship with the inferior gluteal artery. ⋯ In 94.5 percent of the pelvic halve dissections, it was possible to maintain at least a portion of the PFCN intact after isolation of the inferior gluteal artery pedicle while harvesting the free inferior gluteal myocutaneous flap. These findings support a nerve-sparing approach to inferior gluteal myocutaneous flap elevation to minimize the sequela of posterior thigh anesthesia. These data also emphasize the intimate relationship of the PFCN and the gluteal artery and the real possibility of injury to the PFCN during I-GAP harvest.