Fabio NicoliRam M. ChilgarStamatis SapountzisMatthew Sze Wei YeoDavide LazzeriPedro CiudadKidakorn KiranantawatTolga Taha SönmezMichele MarucciaSeong Yoon LimJoannis ConstantinidesHung Chi ChenChina Medical University Hospital TaichungUniversita degli Studi di Roma Tor VergataMaharashtra University of Health SciencesVilla Salaria ClinicMahidol UniversityMedizinische Fakultat und Universitats Klinikum AachenGuy's and St Thomas' NHS Foundation Trust2018-11-232018-11-232015-03-01Microsurgery. Vol.35, No.3 (2015), 169-17610982752073810852-s2.0-84925459677https://repository.li.mahidol.ac.th/handle/20.500.14594/36503© 2014 Wiley Periodicals, Inc. Background Orbital exenteration (OE) is a disfiguring procedure, which typically includes the removal of the entire eyeball including the globe, extraocular muscles, and periorbital soft tissues after malignancies excision or trauma. Several methods of orbital reconstruction have been attempted with varying success. In this report, we analyze results of the use of gracilis muscle free flap for reconstruction of OE defects and its feasibility for prosthetic rehabilitation. Methods Nine consecutive patients treated at the China Medical University Hospital of Taichung during January 2009 to January 2013, who had gracilis free flap reconstruction after OEs, were retrospectively reviewed. Cancer in six patients and trauma in remaining three patients was the cause for OE. Results Nine patients who underwent reconstruction with gracilis free tissue transfer had a successful outcome. There was not any donor or recipient site morbidity; however, one patient was deceased during follow-up period due to metastasis. The mean follow-up period was 23.5 months. Cosmetic results were acceptable both to patients and to surgeons. Conclusions Gracilis free flap to repair OE defects may be a safe alternative for reconstruction. It provides a larger volume of well-vascularized tissue, greater placement flexibility, and minor donor site morbidity without any significant functional deficit.Mahidol UniversityMedicineReviewSCOPUS10.1002/micr.22339