Tensor fascia lata flap reconstruction in groin malignancy

Agarwal AK, Gupta S, Bhattacharya N, Guha G, Agarwal A
Correspondence: Dr Akhilesh Kr Agarwal, akhil2u@rediffmail.com, akhil_g_2002@yahoo.com

ABSTRACT
Introduction Block dissection of inguinal lymph nodes is done in cases of malignant inguinal lymphadenopathy, which requires the removal of skin where it is involved, or elevation of the flaps which have precarious blood supply leading to necrosis. Thus, wound closure presents a big challenge. It can be done either by primary closure which is frequently complicated by necrosis, or by split thickness skin graft which is complicated by rejection on radiotherapy. Another option is to cover the wound by a vascularised pedicled graft. This prospective study was conducted after obtaining clearance from the ethical committee. The results were compared with the accepted complication rates of the operation.
Methods  We presented our experience of coverage of wounds after block dissection of inguinal lymph nodes for malignant deposits in 15 patients (with median age of 46 years) by pedicled tensor fascia lata thigh flap.
Results The results following the surgery were good. Healing was satisfactory in all 15 cases. There were two cases of marginal flap necrosis, and three cases developed lymphoedema which was managed by stockings. There were two cases of infection which were settled by antibiotics. There were three cases of loss of a small area of skin graft at the donor site. There was no reported case of recurrence in the inguinal region.
Conclusion This technique of coverage of the defect after inguinal block dissection is easy with predictable good results.

Keywords: groin malignancy, inguinal block, dissection, tensor fascia lata flap, vascularised pedicled graft
Singapore Med J 2009; 50(8): 781-784