Free SCIA/SIEA skin flap: a dual blood supply approach to groin region

Free groin flap donor skin is unequaled in generous skin supply and inconspicuousness. We reliably utilize this region by taking advantage of the dual blood supply from superficial circumlex iliac (SCIA) and superficial inferior epigastric (SIEA) arteries and name the flap "Free SCIA/SIEA skin flap." The arterial pedicle is selected between SCIA and SIEA according to vascular anatomy which is explored through an incision along the inguinal ligament prior to skin island planning. Among 57 free SCIA/SIEA skin flap transfers, two flap failures occurred; circulatory impairment was restored by taking the patient back to the operating room in four cases; major size discrepancy was noted in one end-to-end arterial anastomosis; and no vein grafts were required. Mostly an extended length of skin island is harvested irrespective of wound size in order to utilize the proximal skin as a vascular carrier that compensates for short pedicle. We conclude that, with the current microsurgical expertise, free SCIA/SIEA skin flap is versatile even when the skin quality is considered.