Back to Groin; Re-Knocking the Door…

Abstract

Background: Old but solid gold. This is the first thing that comes to our mind when we hear the word "Groin Flap". The inimitable flap holds the advantages of being easily harvested with a relatively concealed donor site and very low morbidity. Recently, the goals of reconstruction have rapidly progressed from merely filling a hole to providing an improved function, pleasing aesthetic outcome and minimal to no donor site morbidity. Compared to the bulky conventional groin flap, the Superficial Circumflex Iliac artery Flap perforator (SCIP) fulfills the later requirements by being an already thin flap upon harvest, that doesn't require further de-bulking. This yields thin, pliable tissue with a well-concealed donor site scar and minimal donor site morbidity. In the current study, we represent our experience in using the SCIP flap for various defects of the hand due to different etiologies. Methods: Twenty SCIP flaps were raised superficial to the breaching fascia to cover various defects of the hand and distal forearm during the period of June 2018 to June 2019. Accordingly, with the preservation of the fascia, the flap relies wholly on the superficial branch of the superficial circumflex iliac artery, along with the sub-dermal plexus, sparing the deep branch. Results: Twenty patients (14 males and 6 females) with various injuries to the hand were treated with supra-fascial groin SCIP flap.-The mean age was 26.9 years (range 8-50 years, SD 10.70).-Mean BMI was 27.56Kg/m 2 (20-30 Kg/m 2 , SD 5). Supra-fascial flaps were taken as large as (10cm x 20cm). Mean operative time was 3.05 hours (±0.83), and mean followup was eight months (6-12 months, SD 2.1). All injuries did not require further flap thinning or refashioning. Conclusion: SCIP flap with its supra-fascial dissection can be safely used as an alternative to the conventional groin flap. With its thin nature, better flap in-setting is obtained, the aesthetic outcome is more pleasant and the need for further revisionary debulking surgeries is almost eliminated.