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Freestyle groin flaps: the real axial flap design and clinical application
Wai-Nang Chao1, Chin-Feng Tsai, Po-Hui Wang
1From the *Institute of Medicine and School of Medicine, Chung Shan Medical University, Taichung, Taiwan; †Division of Plastic Surgery, Department of Surgery, Changhua Christian Hospital, Changhua, Taiwan; ‡Chienkuo Technology University, Changhua, Taiwan; §Department of Critical Care Medicine, Chi Mei Medical Center, Tainan, Taiwan; ∥School of Medical Laboratory and Biotechnology, Chung Shan Medical University, Taichung, Taiwan; ¶Clinical Laboratory, Chung Shan Medical University Hospital, Taichung, Taiwan; #Department of Family and Community Medicine.
Background:
The groin flap represents a milestone in the history of flap development, since it was the first successful free cutaneous flap. Once widely used, it is currently less popular owing to the variations in vascular anatomy and the small, short pedicle. To enhance the clinical applications of the groin flap, its merits need to be promoted and its faults improved, including making some useful innovations.
Methods:
From February 2010 to February 2014, we successfully treated 35 patients with soft tissue defects in the extremities (28 patients), buttock (1 patient), and head (6 patients) using new designs in groin flaps: axial free (34 patients) or pedicle (1 patient) groin flaps.
Results:
All types of axial groin flaps survived successfully in the 2 to 38 months' (mean, 15.6 months) follow-up. The branches of the superficial circumflex iliac artery used for the axial flap design were 2 to 4 (mean, 3.09). The flap size ranged from 1×1.5 cm to 11×30 cm. No significant complications developed in any of the patients, with the exception of 2 mildly bulky flaps.
Conclusions:
This axial design of freestyle groin flaps not only preserves the earlier merits of the groin flap but also creates many new advantages: (1) reliability is greater, (2) ability to tailor the dimensions and flap paddles to the lesions, (3) options available to "lengthen" flap pedicles, and (4) local anesthesia usable with free flaps for reconstruction.
