{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,15]],"date-time":"2026-10-15T09:46:52Z","timestamp":1792057612337,"version":"4.4.0"},"reference-count":21,"publisher":"Wiley","issue":"7","license":[{"start":{"date-parts":[[2026,10,15]],"date-time":"2026-10-15T00:00:00Z","timestamp":1792022400000},"content-version":"vor","delay-in-days":14,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,10,1]],"date-time":"2026-10-01T00:00:00Z","timestamp":1790812800000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Microsurgery"],"published-print":{"date-parts":[[2026,10]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:p>Desmoid tumors (DTs) are rare, benign, locally aggressive myofibroblastic neoplasms. Complete resection with negative margins remains the standard treatment despite their lack of metastatic potential. As DT commonly involve the anterior abdominal wall, their excision may result in complex defects requiring advanced reconstruction. We herein present the first functional single\u2010stage reconstruction of an abdominal wall defect with the use of a free innervated gracilis muscle flap transfer. A 29\u2010year\u2010old woman, presented with a palpable tumor on the left\u2010side of her abdominal wall. She underwent surgery and on biopsy, the tumor was diagnosed as a DT. The patient underwent wide resection through an abdominoplasty approach, which resulted in a rectus abdominis defect involving the anterior rectus abdominis sheath. The 8\u2009\u00d7\u20097cm\u2010sized defect was reconstructed with free transfer of a neurotized gracilis muscle flap, anastomosed to the deep inferior epigastric vessels, whereas, the anterior branch of the obturator nerve was coapted to the ninth intercostal nerve. Finally, a monofilament polypropylene mesh was used for reconstruction of the missing anterior rectus sheath. Ever since and during a follow\u2010up of 5\u2009years, electromyographic examinations have demonstrated excellent re\u2010innervation of the gracilis muscle flap. The patient underwent regular follow\u2010up examinations, including CT imaging at 1, 2, and 5\u2009years postoperatively, with no evidence of abdominal wall protrusion or tumor recurrence. This case demonstrates that the free innervated gracilis flap can provide a safe and reliable reconstructive option for complex abdominal wall defects following oncologic resection.<\/jats:p>","DOI":"10.1002\/micr.70306","type":"journal-article","created":{"date-parts":[[2026,10,15]],"date-time":"2026-10-15T09:05:52Z","timestamp":1792055152000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Free Innervated Gracilis Muscular Flap for Functional Abdominal Wall Reconstruction Following Desmoid Tumor Resection: A Case Report and Literature Review"],"prefix":"10.1002","volume":"46","author":[{"given":"Efstathios G.","family":"Lykoudis","sequence":"first","affiliation":[{"name":"Department of Plastic and Burn Surgery Ioannina University School of Medicine  Ioannina Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9020-874X","authenticated-orcid":false,"given":"Marios","family":"Papadakis","sequence":"additional","affiliation":[{"name":"Department of Plastic and Burn Surgery Ioannina University School of Medicine  Ioannina Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0007-9456-9810","authenticated-orcid":false,"given":"Ilias Stylianos K.","family":"Iliadis","sequence":"additional","affiliation":[{"name":"Department of Plastic and Burn Surgery Ioannina University School of Medicine  Ioannina Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"George E.","family":"Lykoudis","sequence":"additional","affiliation":[{"name":"Department of Radiology Ioannina University School of Medicine  Ioannina Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dimitra V.","family":"Peristeri","sequence":"additional","affiliation":[{"name":"Department of Plastic and Burn Surgery Ioannina University School of Medicine  Ioannina Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3658-205X","authenticated-orcid":false,"given":"Ioannis","family":"Dalianoudis","sequence":"additional","affiliation":[{"name":"Department of Plastic and Burn Surgery Ioannina University School of Medicine  Ioannina Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,10,15]]},"reference":[{"issue":"2","key":"e_1_2_11_2_1","doi-asserted-by":"crossref","first-page":"znae040","DOI":"10.1093\/bjs\/znae040","article-title":"Nerve\u2010Preserving Gracilis Transposition and Onlay Mesh for Total Abdominal Wall Functional Reconstruction","volume":"111","author":"Carrara A.","year":"2024","journal-title":"British Journal of Surgery"},{"issue":"3","key":"e_1_2_11_3_1","doi-asserted-by":"crossref","first-page":"211","DOI":"10.1055\/s-0032-1306368","article-title":"Free Tensor Fasciae Latae Flap for Abdominal Wall Reconstruction: Overview and New Innovation","volume":"28","author":"Chalfoun C. 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G.","year":"2019","journal-title":"Anticancer Research"},{"key":"e_1_2_11_5_1","doi-asserted-by":"crossref","first-page":"10","DOI":"10.1016\/j.bjps.2022.11.051","article-title":"To Bulge or Not to Bulge: Rectus Abdominis Functional Reconstruction After Soft Tissue Sarcoma Resection","volume":"78","author":"Fern\u00e1ndez\u2010Garrido M.","year":"2023","journal-title":"Journal of Plastic, Reconstructive & Aesthetic Surgery"},{"issue":"4","key":"e_1_2_11_6_1","doi-asserted-by":"crossref","first-page":"803","DOI":"10.1016\/j.soc.2016.05.010","article-title":"Desmoid\u2010Type Fibromatosis: Evolving Treatment Standards","volume":"25","author":"Fiore M.","year":"2016","journal-title":"Surgical Oncology Clinics of North America"},{"key":"e_1_2_11_7_1","doi-asserted-by":"crossref","DOI":"10.1155\/2016\/8753479","article-title":"Reconstruction of Abdominal Wall Defects Using a Pedicled Anterolateral Thigh Flap Including the Vastus Lateralis Muscle: A Report of Two Cases","volume":"2016","author":"Fukui K.","year":"2016","journal-title":"Case Reports in Surgery"},{"key":"e_1_2_11_8_1","doi-asserted-by":"crossref","DOI":"10.1155\/2012\/315190","article-title":"Functional Reconstruction of Sarcoma Defects Utilising Innervated Free Flaps","volume":"2012","author":"Grinsell D.","year":"2012","journal-title":"Sarcoma"},{"issue":"5","key":"e_1_2_11_9_1","first-page":"5129","article-title":"Effect of Surgical Margins on Prognosis in Aggressive Fibromatosis: A Single\u2010Institutional Analysis of 90 Patients","volume":"14","author":"Harati K.","year":"2017","journal-title":"Oncology Letters"},{"issue":"3","key":"e_1_2_11_10_1","doi-asserted-by":"crossref","first-page":"331","DOI":"10.1097\/SAP.0b013e3182321b64","article-title":"Dynamic Reconstruction of Full\u2010Thickness Abdominal Wall Defects Using Free Innervated Vastus Lateralis Muscle Flap Combined With Free Anterolateral Thigh Flap","volume":"70","author":"Iida T.","year":"2013","journal-title":"Annals of Plastic Surgery"},{"issue":"2","key":"e_1_2_11_11_1","first-page":"199","article-title":"Dynamic Reconstruction of the Abdominal Wall Using a Reinnervated Free Rectus Femoris Muscle Transfer","volume":"43","author":"Koshima I.","year":"1999","journal-title":"Annals of Plastic Surgery"},{"issue":"4","key":"e_1_2_11_12_1","doi-asserted-by":"crossref","first-page":"420","DOI":"10.1097\/01.SAP.0000032304.45784.F6","article-title":"Dynamic Reconstruction of Large Abdominal Defects Using a Free Rectus Femoris Musculocutaneous Flap With Normal Motor Function","volume":"50","author":"Koshima I.","year":"2003","journal-title":"Annals of Plastic Surgery"},{"issue":"6","key":"e_1_2_11_13_1","doi-asserted-by":"crossref","first-page":"1589","DOI":"10.1097\/01.prs.0000187171.60689.48","article-title":"The Conjoint Medial Circumflex Femoral Perforator and Gracilis Muscle Free Flap: Anatomical Study and Clinical Use for Complex Facial Paralysis Reconstruction","volume":"116","author":"Lykoudis E. 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