A myocutaneous flap is a type of autologous graft, consisting of tissue taken from a patient and used on that patient's own body. As the name implies, this graft includes skin and muscle. Myocutaneous flaps can be used in a wide variety of surgical procedures by people like plastic surgeons and burn specialists. If a patient is a good candidate for a procedure involving an autologous graft, the surgeon will discuss the procedure and what to expect to help the patient prepare.
In a free flap procedure, the surgeon cuts a graft from one area of the body and transfers it to another. For example, if a patient is missing skin on the arm due to a burn injury, the surgeon could cut a flap from the leg. Rotated flaps involve cutting out a myocutaneous flap while leaving part of the tissue attached. The flap is rotated to cover the area of concern and then stitched in place. This technique allows the grafted tissue to retain its blood supply while it heals, and can improve patient outcomes.
There are numerous advantages to using autologous grafts, when they are an available option. The risk of rejection is reduced, as are concerns about risks of transmitting disease. The color and texture of the skin can be a better match, making the graft site less obvious, and the tissue is as new and fresh as it is possible to be, which also limits rejection risks. By taking skin and the underlying muscular blood supply in a myocutaneous flap, a surgeon can increase the chances of a smooth healing.
Patients preparing for a myocutaneous flap procedure should know that they will be placed under anesthesia for the procedure. It is possible to cut the graft in a technique known as netting to make it stretch further, limiting the amount of tissue that needs to be removed. The harvest site will eventually heal and grow new skin. During the healing process, it is critically important to take care of both the graft and harvest sites to limit the risk of infection and reduce the chances of graft rejection.
Once a myocutaneous flap successfully takes, it will be thoroughly perfused with blood and capable of repairing injuries, incurring damage from sun exposure, and undergoing other changes with age, just like the skin on the rest of the body. However, a myocutaneous graft will have no sensation, because it is not possible to graft the nerves.