An Innovative Solution to Complex Inguinal Defect: Deepithelialized SIEA Flap With Mini Abdominoplasty

Introduction: We describe a novel technique of contralateral pedicled deepithelialized superficial inferior epigastric artery flaps, followed by abdominal advancement coverage, as an alternative treatment of radiated complicated inguinal or lower abdominal defects, avoiding the donor-site defect typically seen with other methods of coverage. Methods: Two male patients with histories of liposarcoma after excision and radiation to one side of lower abdomen/inguinal area presented with complicated wounds that were reconstructed with this technique. Results: Successful obliteration of dead space and wound closure were achieved with the combination of a superficial inferior epigastric artery flap with an abdominal advancement flap. In each case, patients went on to heal uneventfully without need for any secondary procedures. Discussion: The use of a superficial inferior epigastric artery flap for lower abdomen/groin defect closure is an option as an alternative to rectus abdominis myocutaneous flap and anterolateral thigh flaps and should be considered in patients with vascular anatomy conducive for this muscle-sparing procedure. Conclusions: A second layer-overlay coverage with an abdominal advancement flap creates a more durable repair in the complicated radiated wound and a well-concealed abdominoplasty scar.