Gastrocnemius flaps are commonly used flaps to cover the proximal aspect of the tibia or distal knee joint. Gastroc flaps have become one of my favorite flaps over the years as they can be readily harvested through an extension of a previous incision.
Care should be taken when harvesting the flap to preserve the saphenous vein as this can significantly help the edema that is often present in the re-operative lower extremity. Furthermore, appropriate preservation is helpful as it may be used as a back-up for venous outflow if free tissue transfer is needed.
I find that one of the most helpful maneuvers in the gastroc flap is to remove the fascia from the under surface of the muscle. This allows for the exposure of a raw surface to adhere to the bone or antibiotic spacer. The raw muscle allows greater contact and exposure of surface area to the underlying object.
