The Versatility of the Fasciocutaneous Infragluteal (FCI) Flaps for locoregional or free flap reconstruction

• Published in: Journal of plastic, reconstructive & aesthetic surgery reconstructive & aesthetic surgery, 2022-08, Vol.75 (8), p.2493-2500
• Main Authors: Zaussinger, Maximilian, Wenny, Raphael, Huemer, Georg M., Schmidt, Manfred
• Format: Article
• Language: English
• Subjects: Fasciocutaneous infragluteal flap; FCI; Free flaps; Microsurgery; Perforator flap; Reconstructive surgery
• ISSN: 1748-6815; 1878-0539
• DOI: 10.1016/j.bjps.2022.02.077

The wide range of reconstructive purposes requires specific demands and considerations for appropriate flap selection. One versatile and reliable option, which is rarely reported in current literature, is the fasciocutaneous infragluteal (FCI) flap. In this study, we present our results of performing the FCI flap for different clinical indications. This retrospectively study was conducted between September 2011 and September 2019. We included 30 patients (21 females and 9 males) who underwent reconstruction with either pedicled or free FCI flap. Indications for performing FCI flap were uni- or bilateral autologous breast reconstruction, perineal reconstruction, congenital thoracic deformity, lower extremity coverage, and vulva reconstruction. Forty-one FCI flaps were performed (34 free and 7 pedicled flaps). The average flap dimension was 7  ×  20 cm (range, 7–8  ×  19–21) and the mean length of the pedicle was 13.4 cm (range, 10.5–15.5). The mean diameter of the artery was 2.5 mm (range, 2.2–3.2), the mean diameter of the accompanying vein was 3 mm (range, 2.4–3.3). The flap survival rate was 97.6% (one flap loss). The most common minor complications were infragluteal wound healing disorders and hematoma. The FCI flap provides constant and reliable anatomy with a long vascular pedicle as well as enough soft tissue bulk and a well-hidden scar. In our clinical practice, this flap has emerged as a first choice in perineal/vulvar reconstruction and a reliable alternative in breast reconstruction if the gold standard procedure cannot be performed. IV (Therapeutic)