Surgery Spotlight: Diagonal Upper Gracilis (DUG) Flap-Surgery Spotlight: Diagonal Upper Gracilis (DUG) Flap

Surgery Spotlight: Diagonal Upper Gracilis (DUG) Flap

Video Transcription

Video Summary

In the video, Dr. Joseph Dayan from Memorial Sloan-Kettering discusses the Dug flap, a diagonal upper gracilis myocutaneous free flap technique used for breast reconstruction. The main advantage of the Dug flap is its straight-line closure along lines of least tension, reducing the risk of wound healing complications and allowing for a wider flap compared to other options like the TUG or PAP flap. This method is particularly useful for patients with minimal abdominal fat, as it avoids using the abdomen for tissue harvest. However, the Dug flap does leave a visible scar on the back of the thigh, which might be acceptable or a concern for some patients. Dr. Dayan explains the surgical techniques involved, the importance of avoiding major lymphatic collectors and femoral triangle to prevent complications, and potential postoperative outcomes. While the Dug flap isn't suitable for everyone, it provides an additional reconstructive option, particularly for thin patients without abdominal fat. It's another choice alongside other autologous tissue reconstruction methods like GAP and deep flaps, tailored to individual patient needs and preferences.

Asset Caption

This material is presented thanks to a generous licensing grant from Elsevier, and is taken from Plastic Surgery: 6-Volume Set, 3rd Edition edited by Peter C. Neligan, MD. "Three-Stage Folded Forehead Flap" appears in Volume 3: Craniofacial, Head and Neck Surgery and Pediatric Plastic Surgery.

Surgeon Joseph Dayan, MD

Disclosure

Dr. Dayan has nothing to disclose. All ASPS staff members managing this activity have no relevant financial relationships or affiliations to disclose. All identified conflicts of interest have been resolved and the educational content thoroughly vetted by ASPS for fair balance, scientific objectivity, and appropriateness of patient care recommendations. The ASPS also requires faculty/authors to disclose when off-label/unapproved uses of a product are discussed in a CME activity or included in related materials. This product is not certified for CME.

Keywords

surgery spotlight

Surgical Videos

Breast

Joseph Dayan MD; Memben

Dug flap

breast reconstruction

myocutaneous free flap

straight-line closure

minimal abdominal fat

surgical techniques

autologous tissue reconstruction

postoperative outcomes