Objective To explore the application and clinical effect of free gracilis myocutaneous flap in repairing soft tis
sue defect of the upper extremity. Methods From June 2020 to December 2021, a total of 8 patients (5 males and 3 females)
with soft tissue defects in the upper extremity were repaired by the free gracilis myocutaneous flaps. The causes of soft tissue
defects: traffic accident injury in 3 cases, postoperative infection in 2 cases, hemangioma in 1 case, electric burn scar contrac
ture in 1 case, dog bite in 1 case. Wound site: hand in 2 cases, from the radial side of the back of the hand to the radial side of
the forearm in 1 case, forearm in 4 cases, shoulder in 1 case. The wound ranged from 8 cm×6 cm to 19 cm×12 cm. The skin
flap incision ranged from 10 cm×7 cm to 22 cm×15 cm, including 4 transverse gracilis myocutaneous flaps and 2 longitudinal
gracilis myocutaneous flaps and 2 tricuspid gracilis myocutaneous flaps. The donor site was sutured directly. The survival of flaps
and complications were observed after operation. Regular follow-up was performed. The last follow-up included color, texture,
appearance, sensation of the flap and appearance of the donor site. Results All flaps survived, and the wounds in donor and
recipient sites healed by first intention. Postoperative edema of the donor side occurred in 1 case. The follow-up period ranged
from 6 to 24 months (mean, 18 months). All flaps had good color and texture, with slightly bloated appearance and dull sensation.
Linear scar was left at the donor site, and the appearance was well evaluated. There was no adverse effect on lower limb function.
Conclusion The gracilis musculocutaneous flap has the advantages of strong plasticity, less variation in the anatomy of the
main vessels, and concealed donor site. It is a feasible choice for repairing the soft tissue defects of the upper extremity.