An anatomic study was performed to analyse the proximal perforator vessels of the gracilis musculocutaneous flap. Twenty-three cadaver legs preserved by the method of Thiel were carefully dissected 24 h after the proximal vascular pedicle was injected wit

The reconstruction of large and intricate defects may need the use of combined flaps due to either the size or requirement for multiple surfaces. The combination may be between free and pedicled tissue transfer, and combined or connected free flaps classified by Koshima. We will discuss the use of the Siamese combined free flap as a method of the reconstructing challenging cases, including one of the largest free tissue transfer reported.