Superiorly based perforator plus flap for inguinal defects

Abstract

Aim: Inguinal block dissections for metastasis to inguinal lymph nodes and occasionally trauma are always associated with soft tissue loss over the groin region. A clinical study was undertaken to demonstrate the ability to utilize a superiorly-based perforator flap with reliable vascularity and less donor site morbidity to cover defects in the inguinal region.

Methods: A prospective study was performed on 7 patients with inguinal soft tissue defects managed in our institution from January 2013 to September 2013. During the study period, a ”superiorly-based perforator plus flap” was used for soft tissue coverage over the femoral vessels in the inguinal region. Hyperbaric oxygen therapy was administered postoperatively. The postoperative period, hospital course, and follow-up after radiotherapy was documented in patients with inguinal block dissection.

Results: Seven patients presented with soft tissue defects in the inguinal region. Five of the defects were secondary to prior surgery, and 2 were secondary to trauma. A superiorly-based perforator plus flap was performed in all patients. The defect sizes ranged from 9 cm × 4 cm to 17 cm × 8 cm. The flap dimensions ranged from 12 cm × 5 cm to 20 cm × 10 cm. No secondary procedures were necessary following surgery. Postoperatively, there was no evidence of partial or total flap loss. No flap revisions were required, and no complications were experienced at either the donor or recipient site following radiotherapy. Patients were followed-up for 10-18 months.

Conclusion: Inguinal defects require stable soft tissue coverage to withstand radiotherapy following inguinal block dissection surgery, and are susceptible to wound complications. The superiorly-based perforator plus flap technique is simple, requires little operative time, and is a reliable flap for coverage of the femoral vessels and inguinal region with improved tolerance to postoperative radiotherapy.

Keywords

Hyperbaric oxygen therapy / inguinal lymph nodes / soft tissue defect / superiorly-based perforator plus flap

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