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Original Article



Reducing the morbidity of groin flap in microsurgical era

Yawar Nissar, Umar Farooq Baba, Adil Hafeez Wani.




Abstract

Introduction:
Groin flap has been a workhorse flap for compound defects of hand and wrist. Microvascular free flaps and local pedicled flaps have replaced it in recent times as the procedure of choice. The drawbacks of groin flap include a two-stage operation, possible risk of shoulder and elbow stiffness, considerable discomfort, less satisfactory cosmesis, need for secondary defatting procedures and a lengthy hospital stay.
Methods:
In the Department of Plastic and Reconstructive Surgery, 48 patients with soft tissue hand and wrist defects were covered with pedicled groin flaps(50 groin flaps), raised between 2017 and 2020 for the coverage of soft tissue hand and wrist defects, were prospectively evaluated.
Results :
All patients were emergencies, machine injuries being the most common. Local complications such as partial flap necrosis, and infection developed in 4 cases (8%). No total dehiscence, total necrosis, and/or hematoma were reported in any patient. In 32 of the flaps (64%), subsequent defatting was required. The median duration of hospital stay was 5 days (range 2-38), and only 6 patients (12.5%) were discharged from the hospital after the division of the pedicle. All patients developed stiffness of the shoulder, elbow, wrist and hand joints after the division of the pedicle which was temporary and resolved with physiotherapy with a median time of 17 days (range 6-33 days ).
Conclusion:
We have attempted ways to reduce the morbidity of the classic groin flap safely. As the pedicled groin flap has been the workhorse flap for several years at our unit, we were able to review a series of forty eighty patients.

Key words: Groin flap, flap cover, hand defects, wrist defects, microsurgical free flap, trauma, machine injury






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