An update on incision for ilioinguinal lymph node dissection

The wound morbidity after ilioinguinal lymph node dissections can be significantly reduced by precise planning of both the incision and the extent of flap elevation. Flap elevation extends no farther than the edges of the quadrilateral block of Anson, and exposure is best obtained with a bipedicle incision with broad-based pedicles. The broad bases ensure the greatest possibility for the sustentation of the flaps by the remaining microcirculation. All suction drains are placed far laterally, not through the base of any flaps, to avoid the high bacterial count on the skin of the groin, genitals, perineum, and anus. Closure is undertaken with a running suture, which allows for a seal that will facilitate suction. Suction continues until drainage is less than 25 mL/d.