Important considerations in the design and construction of groin flaps

A method for constructing groin flaps is presented which the author has used successfully. The flap is elevated medial to the sartorius muscle. The lateral femoral cutaneous nerve is preserved. The muscular branch is carefully divided to avoid damage to the superficial circumflex iliac artery. Near the femoral artery, the important draining vein, which often diverges from the cutaneous artery, must be preserved. One side of the flap is cut longer than the other and diagonal closure of the donor site and the flap are performed. This diagonal closure increases the circumference of the tube at the base of the flap, thereby reducing the risk of vascular compression. Diagonal closure also produces a spiral in the tube. The direction of the spiral can be controlled to facilitate closure of defects on the palm or dorsum of the hand.