Shotgun blast injuries to the groin: reconstruction using the rectus abdominis flap

We discuss our successful management of complex groin wounds caused by shotgun blasts at relatively short range. A straightforward approach to the problem of reconstructing the large soft-tissue defect and providing protection for the femoral artery reconstituted by Gore-Tex graft is described. We emphasize the fundamental principles of management of civilian trauma and illustrate that a Gore-Tex graft need not be covered immediately if there is any possibility that debridement is incomplete. The inferiorly based rectus abdominis flap is recommended as an excellent choice for coverage of the typical shotgun blast groin wound, making it possible to salvage the involved lower extremity in these severe injuries.