Groin Flap: A Vital Resource for Upper Limb Reconstruction in Low-Resource Settings

Complex wounds, particularly in the upper limb, can lead to significant functional loss despite seemingly small size. Free flap surgery is often preferred for resurfacing; however, it requires microsurgery, which may not be readily available in resource-poor settings. This study explores the use of groin flaps for soft tissue coverage in managing complex injuries of the upper limbs.

All consecutive patients with upper limb wounds which were not feasible for closure using direct apposition, skin grafting, or local flaps that presented to the Division of Plastic and Reconstructive Surgery, Department of Surgery of Jos University Teaching Hospital between February 2016 and August 2022, were assessed, counselled and consented for groin flaps. Data on clinical presentation, operative procedure and outcomes were retrieved from their case notes and entered into a proforma.

Fourteen patients were operated on during the period under review. Their ages ranged from 6 to 64 years with a mean of 27 ± 7 years and a median age of 25 years. All wounds had traumatic aetiology, except one which was from an infection, with road traffic collision accounting for six, assault accounting for five, and one each for fall, occupational injury and infection. Ten (71%) percent of these defects were in the hand with four around the arm and forearm. Of the hand wounds, six were on the dorsum, one on the palm, and three on the fingers. The average area of the wound covered was 60 cm², with a range of 12 cm² to 140 cm².

Despite advances in flap surgery, with a free flap in the fore, there is still room for groin flaps to be used in coverage of upper limb wounds, especially in resource-poor countries where expertise and resources for free flap might be unavailable.