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J Hand Microsurg 2018; 10(02): 101-104
DOI: 10.1055/s-0038-1626686
Case Report
Thieme Medical and Scientific Publishers Private Ltd.

Intramuscular Lipoma within a Free Myocutaneous Flap: Systematic Review and Management

Elizabeth M. Kenny
1   Department of Plastic Surgery, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania, United States
,
Francesco M. Egro
1   Department of Plastic Surgery, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania, United States
,
Tahsin Oğuz Acartürk
1   Department of Plastic Surgery, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania, United States
› Author Affiliations Funding None.
Further Information

Publication History

Received: 02 September 2017

Accepted: 02 December 2017

Publication Date:
20 March 2018 (online)

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Abstract

Lipomas are a common finding often of little clinical significance, but they can pose a challenge to the microsurgeon if discovered during flap harvesting, especially if found within the muscle along the pedicle or perforators. Here the authors report a case in which a well-circumscribed intramuscular lipoma was discovered within the muscle of a free myocutaneous right anterolateral thigh (ALT) vastus lateralis free flap. To the authors’ knowledge, the management of lipoma during flap harvesting has not been previously discussed in the literature. A systematic review was performed, and an approach for the management of myocutaneous flaps containing a lipoma was described. Underappreciated considerations including lipoma location, growth pattern, and proximity to pedicle and perforators must be taken into account when evaluating a lipoma during flap harvest.

Keywords

lipoma - free flaps - review - systematic - approach - microsurgery
 

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