McCraw JB, Massey FM, Shanklin KD et al (1976) Vaginal reconstruction with gracilis myocutaneous flaps, Plast Reconstr Surg 58:176-83.
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Underlying anatomy of medial thigh
1 Adductor magnus muscle
2 Adductor longus muscle
4 Great sartorius muscle
5 Semitendinosus muscle
7 Semimembranosus muscle
Outline of skin island over proximal two-thirds of gracilis muscle
Skin and cutaneous skin island incised and distal gracilis muscle identified near knee
Myocutaneous flap elevated. Note neurovascular pedicle entering into proximal third of muscle
Myocutaneous flap exteriorized through the introitus
Bilateral gracilis myocutaneous flaps sewn together
Bilateral flaps shaped into a pouch
Neo-vaginal pouch inserted into pelvic space and sutured to the introitus
Partial anterior and posterior defect repair
Skin subcutaneous tissue and deep fascial incision
A suture of lateral margins of bilateral flaps to each other
Skin island on labium majus
Mobilization of skin island
Tunnel from vaginal wall to base of myocutaneous flap
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