Pedicled groin flap for soft tissue coverage

Abstract

Background. The groin flap is a vascularized axial flap based on the superficial circumflex iliac artery arising from the femoral artery just below the inguinal ligament. It is regularly used by many reconstructive surgeons to cover soft tissue defects of the abdomen, hand, arm and forearm. The groin flap has several advantages including adequate skin thickness and minimal donor site morbidity, making it the most usable free flap for soft tissue coverage. The disadvantages of the flap include a rather short pedicle and the small artery size. The groin flap was the first successful skin and soft tissue free flap, described by McGregor and Jackson in 1972. It provides a large amount of skin coverage with an easily restored donor site. Groin flap is a viable option for patients who are not candidates for free tissue transfer because of comorbidities and when the utility of microvascular technique is not feasible. We present a case report outlining the effectiveness and usefulness of this type of pedicled flap. Case report. A 68-year-old woman sustained a cholecystectomy in the surgery department, which was complicated postoperatively with ventral hernia of the abdominal wall. It was made an attempt to resolve it with the surgical treatment, but 12 days after the surgery, the patient presented a soft tissue defect, a surgical mesh on the abdomen wall being visualized. It was decided to perform surgical treatment of the abdominal defect and plastic surgery with vascularized groin flap. Necrosis of the cutaneous flap component occurred postoperatively. But fascia which remained viable was sufficient to cover the surgical mesh and served as a vascular bed for free split skin graft. Conclusions. We believe that the pedicled groin flap can be used safely and effectively in the soft tissue coverage. At the same time, it can preserve the aesthetic and functional properties of tissues. The technique is quick, facile, and reliable, with few complications. Despite the fact that this type of flap is used less, it represents the optimal solution in the case of lack of skin tissue and soft tissue. This case report demonstrates the versatility of the groin flap in closing complex soft tissue defects of the abdomen wall.