The pedicled groin flap in resurfacing hand burn scar release and other injuries: a five-case series report and review of the literature (original) (raw)
Related papers
Groin Flap: A Good Converge for Hand
2006
Summary: Fifty cases of hand trauma of different aetiology with soft tissue loss with exposed tendons and bones were treated in NITOR and DMCH, Dhaka between January '97 and December '02 with groin flap. Eighty three percent (83%) cases have good results with excellent flap adhesion and no flap loss. Seventeen percent (17%) cases have some degree of flap loss
Groin Flap: A Good Converge for Hand Injury
Journal of Medicine, 2008
Fifty cases of hand trauma of different aetiology with soft tissue loss with exposed tendons and bones were treated in NITOR and DMCH, Dhaka between January '97 and December '02 with groin flap. Eighty three percent (83%) cases have good results with excellent flap adhesion and no flap loss. Seventeen percent (17%) cases have some degree of flap loss which were taken to be acceptable. Overall result in terms of restoring the hand function was encouraging which was approximately eighty eight percent (88%). Â DOI = 10.3329/jom.v7i1.1357 J MEDICINE 2006; 7 : 15-19
Journal of Evidence Based Medicine and Healthcare
BACKGROUND In reconstruction of post burn scar contracture of hand, thumb reconstruction is crucial. Among various flaps that are available for thumb reconstruction groin flap is ideal for large defects and defects also involving 1 st webspace. Modification in groin flap with fenestration provides more inset, splints thumb in abduction thereby maintaining 1 st web space and no soddening of thumb and 1 st web space. METHODS In a 2-year period between 2017 and 2019, fenestrated groin flap was performed. It was done in 12 cases of which 9 were males and 3 were females. RESULTS All 12 patients had Post-burn Dorsal Contracture (PBSC). The time interval between injury and reconstruction ranges from 10 months to 8 years (mean 3.25). All patients after contracture release were reconstructed with fenestrated groin flap in 2 stages. After 2 weeks flaps were divided and remaining insets were given. Donor sites were closed primarily by undermining or resurfaced with SSG where necessary. All flaps survived with no postoperative complication. CONCLUSIONS Based on our experience with fenestrated groin flap, this is an ideal flap after release of dorsal PBSC thumb.
Reducing the morbidity of groin flap in microsurgical era
International Journal of Surgery and Medicine, 2022
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 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, 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 hospital after 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.
Current indications for abdominal-based flaps in hand and forearm reconstruction
Injury-international Journal of The Care of The Injured, 2020
Extensive soft tissue loss or injury of the hand and upper extremity is a challenging reconstructive problem traditionally treated with abdominal-based pedicled flaps. Options for coverage included the groin flap based on the superficial circumflex iliac artery, the Scarpa's fascia flap based on the superficial inferior epigastric artery, and the paraumbilical perforator flap from the deep inferior epigastric artery perforators. Despite the ability to provide consistent and pliable soft tissue coverage with ease of elevation, these flaps have several disadvantages including restriction of mobility, requirement for multiple procedures, bulkiness and patient discomfort. With the advent of microsurgery, pedicled regional flaps, and off-the-shelf skin substitutes, the applications for these flaps have narrowed. However several indications still remain. These include: patient and facility factors which deter microsurgery, the absence of recipient vessels after injury, prior surgical use of recipient vessels, the need to preserve major vessels for future reconstruction, and large multi-surface wounds requiring coverage. In this review we detail these indications and provide case examples for each.
Superficial Circumflex Iliac Artery Free Flap for Coverage of Hand Injuries
Cureus
Open de-gloving hand injuries with exposed tendons and bones require coverage by a flap. Conventionally used groin or abdominal flaps are cumbersome to patients due to extensive dressing and prolonged passive positioning of the hand until pedicle division. Superficial circumflex iliac artery (SCIA) flap is evolved from a traditional groin flap, and because of its thinness, pliability, and concealed donor site, it is an ideal option for single-stage reconstruction of traumatic hand defects avoiding discomforting passive hand position, joint stiffness, and unexpected flap avulsion which were associated with traditional groin flap. All patients with exposed bones or tendons due to traumatic hand injuries who opted for free flap coverage during the year 2018 to 2020 were enrolled in our study. After initial debridement, the wound was covered with a free SCIA flap. Duration of hospital stay, days out of work, the number of dressings required, postoperative complications, and any secondary procedures for flap readjustment were noted till six months postoperatively. A total of eight patients were included in the study. The mechanism of injury was road traffic accidents in a single patient and occupational injury in eight patients. The average duration of hospital stay was six days after reconstructive surgery. The average number of dressings a patient had was 18, and only two patients required flap thinning. Only one patient had a postoperative infection which was managed with dressings and antibiotics. One patient had peripheral flap necrosis. We had zero flap reexploration. Therefore, we conclude that hand defects coverage with SCIA flap leads to a smaller number of working days lost and rarely requires secondary procedures.
The American Journal of Case Reports, 2021
Patient: Male, 44-year-old Final Diagnosis: Amputed left hand distal to the wrist joint Symptoms: Amputed left hand distal to the wrist joint Medication: — Clinical Procedure: Replantation of amputaed hand augmented with fasciocutaneous left groin flap Specialty: Orthopedics and Traumatology • Plastic Surgery • Rehabilitation • Surgery Objective: Management of emergency care Background: Upper limb replantation has become an almost routine procedure, with digital and hand reattachments being the most commonly performed. These remain challenging procedures to reconstructive surgeons, especially when there is trauma to the detached limb. Injury to the overlying skin and soft tissue can lead to tissue necrosis, sepsis, and loss of the replanted limb. The use of skin grafts as well as a wide variety of muscular, musculo-cutaneous, fascio-cutaneous flaps, and free-transfer grafts has significantly diminished limb loss. We report on the use of a delayed fascio-cutaneous, pedicled groin fla...