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Prelaminated BMG-Gracilis Flap

Prelaminated buccal mucosa-gracilis flap reconstruction is a two-stage salvage technique in which buccal mucosal grafts are first sutured onto the gracilis muscle and allowed to epithelialize before the composite flap is used for urethral reconstruction. The prelamination period creates a durable mucosal lining on a well-vascularized muscular base. This highly complex approach is reserved for the most challenging cases, including radiation necrosis, recurrent fistulae, and lichen sclerosus with pan-urethral obliteration.

Indications

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Technique Overview

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Key Steps

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Outcomes & Evidence

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References

  1. Nikolavsky D, Abouelleil M, Daneshvar M. "Prelaminated gracilis flap with buccal mucosal graft for salvage of devastated urethra." Case Rep Urol. 2015;2015:397829. PMID: 26257976
  2. Zinman L. "Muscular, myocutaneous, and fasciocutaneous flaps in complex urethral reconstruction." Urol Clin North Am. 2002;29(2):443–66.