fig8

Figure 8. The anterior incision is made first. Dissection is carried down through the fascia surrounding the gracilis muscle, which is then retracted anteriorly. The investing fascia of the adductor magnus is incised behind the gracilis muscle, and a subfascial dissection continues posteriorly until perforators are identified. (A) The perforators are dissected retrograde through the adductor magnus muscle, sparing the muscle and muscular nerves supplying it. This continues until adequate length and caliber vessels are obtained (B). Two perforators that joined quickly in the muscle were chosen for perfusion for this left-sided diagonal PAP flap. (PAP = profunda artery perforator).