Tensor fascia lata flap reconstruction following groin dissection: is it worthwhile?

Abstract

To compare the morbidity of primary skin closure with elective Tensor Fascia Lata (TFL) flap cover in groin dissections. This was a retrospective study between January 2007 and December 2009. All patients undergoing groin dissections without skin involvement were included. Of the twenty-five patients, who underwent groin dissections, 14 had primary skin closure (28 groin dissections)-group I. Eleven had TFL flap cover as a means of primary reconstruction (20 groin dissections)-group II. In group I, there were 16 (57%) inguinal dissections and 12 (43%) ilioinguinal block dissections, whereas 82% in group II underwent ilioinguinal dissections (p=0.09). Wound infection requiring treatment with a culture specific antibiotic was required in 4 (14%) in group I (n=28) and only 1 (5%) in group II (n=20) (p=0.38). In group I, 7 (25%) had major flap necrosis and minor necrosis was seen in another 7 (25%). Only three (15%) in group II developed minor flap necrosis (p=0.01). Following an ilioinguinal dissection, flap necrosis occurred in 75% of groins that underwent primary closure and in 17% of those which were reconstructed with TFL (p=0.001). Seroma formation was seen in 5 (18%) in group I and 3 (15%) in group II (p=1.0). Lymphoedema occurred in equal numbers in both groups. The duration of hospital stay was 20±14days in the primary closure group and 16±3days in the TFL group. The TFL flap can reduce postoperative morbidity and decrease hospital stay. Prophylactic TFL flap reconstruction following ilioinguinal dissections is advisable.