Reconstructive Surgery of Inguinal Defects: A Systematic Literature Review of Surgical Etiology and Reconstructive Technique.

Abstract

This study aimed to evaluate the literature regarding surgical etiology demanding inguinal reconstructive surgery, associated reconstructive techniques and outcomes. A systematic literature search was performed according to the PRISMA statement between 1996-2016. A total of 64 articles were included, comprising 816 patients. Two main subgroups of patients were identified: Oncological resections (n=255, 31%), and vascular surgery (n=538, 66%). Oncological resection inguinal defects were treated with pedicled myocutaneous flaps (n=166, 65%), fasciocutaneous flaps (77, 31%), muscle flaps (7, 3%) and direct closure (3, 1%). Vascular surgery complications were treated with muscle flaps (n=513, 95%). Complications for the respective subgroup (oncological resections, vascular surgery) were: infection (24%, 14%), seroma (34%, 7.5%), flap dehiscence/delayed healing (20.6%, 40.8%,). The total reintervention rate was 20%. Reconstruction of inguinal defects should be addressed on a case-by-case basis. Myocutaneous flaps were favoured after oncological resections, while muscle flaps were preferred after vascular surgery.