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Surgical and Anatomic Considerations of Malignancies Affecting the Groin: Reconstructive Approaches to the Groin

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Malignancies of the Groin

Abstract

There has been an increasing demand for reconstructive surgery in acute or chronic groin wounds resulting from burn, trauma patients with oncologic defects following groin lymphadenectomy due to urogenital and lower limb malignancies and complications of infrainguinal vascular bypass surgeries. The reconstructive surgeon has to select the optimal soft tissue coverage after considering the patient’s comorbidities, postoperative quality of life, and functional outcome. In this chapter, we will review the reconstructive options regarding complex wounds in the inguinal region, a brief description of the reconstructive technique, reported outcomes, and comparison between options including use of grafts and flaps.

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References

  1. Horch R, Stark GB. Prosthetic vascular graft infection--defect covering with delayed vertical rectus abdominis muscular flap (VRAM) and rectus femoris flap. Vasa. 1994;23:52–6.

    CAS  PubMed  Google Scholar 

  2. Murthy V, Gopinath KS. Reconstruction of groin defects following radical inguinal lymphadenectomy: an evidence based review. Indian J Surg Oncol. 2012;3:130–8.

    Article  PubMed  PubMed Central  Google Scholar 

  3. Aslim EJ, Rasheed MZ, Lin F, Ong YS, Tan BK. Use of the anterolateral thigh and vertical rectus abdominis musculocutaneous flaps as utility flaps in reconstructing large groin defects. Arch Plast Surg. 2014;41:556–61.

    Article  PubMed  PubMed Central  Google Scholar 

  4. LoGiudice JA, Haberman K, Sanger JR. The anterolateral thigh flap for groin and lower abdominal defects: a better alternative to the rectus abdominis flap. Plast Reconstr Surg. 2014;133:162–8.

    Article  CAS  PubMed  Google Scholar 

  5. Parrett BM, Winograd JM, Garfein ES, Lee WP, Hornicek FJ, et al. The vertical and extended rectus abdominis myocutaneous flap for irradiated thigh and groin defects. Plast Reconstr Surg. 2008;122:171–7.

    Article  CAS  PubMed  Google Scholar 

  6. Perez-Burkhardt JL, Gonzalez-Fajardo JA, Carpintero LA, Mateo AM. Sartorius myoplasty for the treatment of infected groins with vascular grafts. J Cardiovasc Surg (Torino). 1995;36:581–5.

    CAS  Google Scholar 

  7. Larson JD, Altman AM, Bentz ML, Larson DL. Pressure ulcers and perineal reconstruction. Plast Reconstr Surg. 2014;133:39e–48e.

    Article  CAS  PubMed  Google Scholar 

  8. Simman R. Wound closure and the reconstructive ladder in plastic surgery. J Am Col Certif Wound Spec. 2009;1:6–11.

    PubMed  PubMed Central  Google Scholar 

  9. Ratner D. Skin grafting. Semin Cutan Med Surg. 2003;22:295–305.

    Article  PubMed  Google Scholar 

  10. Ogawa R, Hyakusoku H, Ono S. Useful tips for successful skin grafting. J Nippon Med Sch. 2007;74:386–92.

    Article  PubMed  Google Scholar 

  11. Fujioka M. Surgical Reconstruction of Radiation Injuries. Adv Wound Care (New Rochelle). 2014;3:25–37.

    Article  Google Scholar 

  12. Payne WG, Walusimbi MS, Blue ML, Mosiello G, Wright TE, et al. Radiated groin wounds: pitfalls in reconstruction. Am Surg. 2003;69:994–7.

    PubMed  Google Scholar 

  13. Schoeman BJ. The tensor fascia lata myocutaneous flap in reconstruction of inguinal skin defects after radical lymphadenectomy. S Afr J Surg. 1995;33:175–8.

    CAS  PubMed  Google Scholar 

  14. Lin SJ, Nguyen MD, Chen C, Colakoglu S, Curtis MS, et al. Tissue oximetry monitoring in microsurgical breast reconstruction decreases flap loss and improves rate of flap salvage. Plast Reconstr Surg. 2011;127:1080–5.

    Article  CAS  PubMed  Google Scholar 

  15. Lohman RF, Langevin CJ, Bozkurt M, Kundu N, Djohan R. A prospective analysis of free flap monitoring techniques: physical examination, external Doppler, implantable Doppler, and tissue oximetry. J Reconstr Microsurg. 2013;29:51–6.

    Article  PubMed  Google Scholar 

  16. Sinna R, Boloorchi A, Mahajan AL, Qassemyar Q, Robbe M. What should define a “perforator flap”? Plast Reconstr Surg. 2010;126:2258–63.

    Article  CAS  PubMed  Google Scholar 

  17. Maser B, Vedder N, Rodriguez D, Johansen K. Sartorius myoplasty for infected vascular grafts in the groin. Safe, durable, and effective. Arch Surg. 1997;132:522–5. discussion 525-526

    Article  CAS  PubMed  Google Scholar 

  18. Chen SH, Hentz VR, Wei FC, Chen YR. Short gracilis myocutaneous flaps for vulvoperineal and inguinal reconstruction. Plast Reconstr Surg. 1995;95:372–7.

    Article  CAS  PubMed  Google Scholar 

  19. Shih PK, Cheng HT, Wu CI, Chang SC, Chen HC, et al. Management of infected groin wounds after vascular surgery. Surg Infect (Larchmt). 2013;14:325–30.

    Article  Google Scholar 

  20. Fischer JP, Mirzabeigi MN, Sieber BA, Nelson JA, Wu LC, et al. Outcome analysis of 244 consecutive flaps for managing complex groin wounds. J Plast Reconstr Aesthet Surg. 2013;66:1396–404.

    Article  PubMed  Google Scholar 

  21. Ducic I, Dayan JH, Attinger CE, Curry P. Complex perineal and groin wound reconstruction using the extended dissection technique of the gracilis flap. Plast Reconstr Surg. 2008;122:472–8.

    Article  CAS  PubMed  Google Scholar 

  22. Hasen KV, Gallegos ML, Dumanian GA. Extended approach to the vascular pedicle of the gracilis muscle flap: anatomical and clinical study. Plast Reconstr Surg. 2003;111:2203–8.

    Article  PubMed  Google Scholar 

  23. Lannon DA, Ross GL, Addison PD, Novak CB, Lipa JE, et al. Versatility of the proximally pedicled anterolateral thigh flap and its use in complex abdominal and pelvic reconstruction. Plast Reconstr Surg. 2011;127:677–88.

    Article  CAS  PubMed  Google Scholar 

  24. Combs PD, Sousa JD, Louie O, Said HK, Neligan PC, et al. Comparison of vertical and oblique rectus abdominis myocutaneous flaps for pelvic, perineal, and groin reconstruction. Plast Reconstr Surg. 2014;134:315–23.

    Article  CAS  PubMed  Google Scholar 

  25. Alkon JD, Smith A, Losee JE, Illig KA, Green RM, et al. Management of complex groin wounds: preferred use of the rectus femoris muscle flap. Plast Reconstr Surg. 2005;115:776–83. discussion 784–75

    Article  CAS  PubMed  Google Scholar 

  26. Chatterjee A, Kosowski T, Pyfer B, Fisher CS, Tchou JC, et al. A cost-utility analysis comparing the sartorius versus the rectus femoris flap in the treatment of the infected vascular groin graft wound. Plast Reconstr Surg. 2015;135:1707–14.

    Article  CAS  PubMed  Google Scholar 

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Correspondence to Albert Losken M.D., F.A.C.S. .

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Razavi, S.A., Desai, K.A., Liao, A., Losken, A. (2018). Surgical and Anatomic Considerations of Malignancies Affecting the Groin: Reconstructive Approaches to the Groin. In: Delman, K., Master, V. (eds) Malignancies of the Groin. Springer, Cham. https://doi.org/10.1007/978-3-319-60858-7_15

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  • DOI: https://doi.org/10.1007/978-3-319-60858-7_15

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  • Publisher Name: Springer, Cham

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  • Online ISBN: 978-3-319-60858-7

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