Intérêt du lambeau inguinal libre. À propos de 19 cas

Abstract

The pedicled groin flap, well known for the hand resurfacing, has first been described by Mac Gregor in 1972. But the free groin flap is unpopular because of its short (5mm) and small artery (caliber 1,5 to 2mm) and a bulky aspect. The purpose of this study is to show its interest by weighing up the pros and cons of its advantages and of its disadvantages. This study concerns 19 cases of free groin flap for posttraumatic reconstruction of limbs between 1994 and 2009. The patients including six children, were 10 males and nine females, ages from 4 to 50 years old. The size flap ranged from 4×10 to 15×25cm. We reported the indications, the wound's size, the postoperative complications and the quality of life. We observed one total necrosis and three partial necrosis. One debulking was generally required. The free groin flap has a lot of valuable qualities: a good vascularisation, allowing a big size flap (20×30cm), with direct closing of the donor site, in only one surgical installation, without sacrifying a muscle. The scar of the donor site is easily hidden by underwear. The flap's skin has good quality, without hair, and the antifibrotic effect of the fat permits a good tendinous sliding. Compared to the pedicled groin flap, this free technique enables the reconstruction of the lower limbs, while upper limbs are free, without weaning time. The functional and aesthetic result of the reconstruction is good and we think that for a microsurgical team, this reliable flap should be more chosen for the posttraumatic reconstruction of limbs.