Covering large groin defects with the tensor fascia lata musculocutaneous flap

Hill, H. Louis; Hester, Roderick T.; Nahai, Foad

doi:10.1016/0007-1226(79)90052-3

Cited by 26 publications

(7 citation statements)

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“…1,3,4,12–14,17,29–31 The advantages of muscle flaps are numerous and include increased blood supply to the operated area, bringing with it oxygen, nutrients, leukocytes, and systemic antibiotics. 4 The dead space left after extensive debridement of necrotic tissue can be filled by the patient’s own tissue, reducing the risk for potential complications and recurrent infections.…”

Section: Discussionmentioning

confidence: 99%

“…1,10,13–16 Although NWPT has shown to be a valuable treatment option, there are situations where stable wound coverage cannot be obtained with such a modality alone. In a case report from 1979, Hill et al 17 used a combination of sartorius muscle (SM) flap and tensor fascia lata (TFL) musculocutaneous flap to cover the femoral vessels and close a groin wound after tumor resection. To our knowledge, there are no publications that report on this flap combination in the treatment of groin infections following arterial revascularization procedures.…”

Section: Introductionmentioning

confidence: 99%

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The Marriage of Sartorius and Tensor Fasciae Latae in Treating Vascular Prosthetic Graft Infections

Zoepke

Weerd

2017

Plastic and Reconstructive Surgery - Global Open

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Background:Vascular prosthetic graft infection in the groin is associated with high morbidity and mortality. This article presents a case series on the use of 2 flaps in the treatment of this condition.Methods:Five patients, mean age 65 years (range, 49–74 years), with significant comorbidity were treated for an exposed and infected vascular prosthetic graft in the groin with a combination of sartorius muscle (SM) flap and tensor fascia lata (TFL) myocutaneous flap after debridement and start of microbiologic culture–guided antibiotic treatment. The SM flap was used to cover the exposed graft. To obtain stable wound coverage, the SM and remaining groin defect were closed with a pedicle TFL flap.Results:All flaps survived, with only 1 TFL flap suffering a small tip necrosis. All patients obtained stable wound coverage. Donor-site morbidity was minimal. During the follow-up, mean 46 months (range, 15–79 months), 1 patient had a recurrence after 15 months due to a kink in the elongated prosthetic graft that protruded through the skin alongside the SM and TFL flaps.Conclusions:The combination of SM and TFL flaps could be a new treatment option for patients who have an exposed and infected vascular prosthetic graft in the groin. This flap combination could also be used as a prophylactic procedure for those patients with a high risk to develop such a serious complication.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

The Marriage of Sartorius and Tensor Fasciae Latae in Treating Vascular Prosthetic Graft Infections

Zoepke

Weerd

2017

Plastic and Reconstructive Surgery - Global Open

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“…sartorius, rectus abdominis, rectus femoris, gracilis, abdominal skin flaps and TFL flap [9]. Potential disadvantages, as mentioned in the literature, would be the following: abdominal weakness, bulging or hernia (the use of rectus abdominis muscle flap) [10], lateral thigh paresthesia (the use of anterior thigh flap) [11], significant knee weakness (rectus femoris muscle flap) [12], large defect of the donor site and excessive bulkiness on the recipient site (use of muscular flaps in general) [12,13,14]. The consensus which flap represents the best suitable choice does not exist; nevertheless, the use of local instead of free flaps, if possible, remains justified [15].…”

Section: Discussionmentioning

confidence: 99%

“…The TFL muscle is a thin, flat muscle, with a single dominant vascular pedicle (Type I flap by Kormack Lamberty). The flap showed great success with relatively low donor site morbidity, compared to other flaps [13,14,16]. The advantages of the TFL flap would be the following: the involvement of well-vascularized tissue composed of thin sensate skin, thin subcutaneous tissue, and muscle, including large amount of durable fascia; long arch of rotation, and broad coverage area of up to 600 cm 2 .…”

Section: Discussionmentioning

confidence: 99%

Tensor fascia lata flap is a workhorse for defects after inguinal lymph node block dissection

2016

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Having in mind that TFL presents as a flap of adjustable size, length, shape, and volume, with negligible donor site morbidity, and after comparing of our results to those of other authors, we advise broader use of TFL flap. As a reliable flap, not too difficult to harvest, with a low complication rate, it must be taken into consideration regarding the benefits for the patient, and, on the other hand, the surgery cost and duration.

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“…A reliable flap to use is the tensor fascia lata flap which is based on the ascending branch of the lateral circumflex femoral artery. Because of its proximity to the groin, it is a workhorse flap for the region and has been used successfully for large defects [11,12]. It is associated with minimal functional morbidity, and the donor site can be skin grafted.…”

Section: Discussionmentioning

confidence: 99%

Use of the Anterolateral Thigh and Vertical Rectus Abdominis Musculocutaneous Flaps as Utility Flaps in Reconstructing Large Groin Defects

et al. 2014

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BackgroundGroin dissections result in large wounds with exposed femoral vessels requiring soft tissue coverage, and the reconstructive options are diverse. In this study we reviewed our experience with the use of the pedicled anterolateral thigh and vertical rectus abdominis musculocutaneous flaps in the reconstruction of large groin wounds.MethodsGroin reconstructions performed over a period of 10 years were evaluated, with a mean follow up of two years. We included all cases with large or complex (involving perineum) defects, which were reconstructed with the pedicled anterolateral thigh musculocutaneous or the vertical rectus abdominis musculocutaneous (VRAM) flaps. Smaller wounds which were covered with skin grafts, locally based flaps and pedicled muscle flaps were excluded.ResultsTwenty-three reconstructions were performed for large or complex groin defects, utilising the anterolateral thigh (n=10) and the vertical rectus abdominis (n=13) pedicled musculocutaneous flaps. Femoral vein reconstruction with a prosthetic graft was required in one patient, and a combination flap (VRAM and gracilis muscle flap) was performed in another. Satisfactory coverage was achieved in all cases without major complications. No free flaps were used in our series.ConclusionsThe anterolateral thigh and vertical rectus abdominis pedicled musculocutaneous flaps yielded consistent results with little morbidity in the reconstruction of large and complex groin defects. A combination of flaps can be used in cases requiring extensive cover.

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Covering large groin defects with the tensor fascia lata musculocutaneous flap

Cited by 26 publications

References 1 publication

The Marriage of Sartorius and Tensor Fasciae Latae in Treating Vascular Prosthetic Graft Infections

The Marriage of Sartorius and Tensor Fasciae Latae in Treating Vascular Prosthetic Graft Infections

Tensor fascia lata flap is a workhorse for defects after inguinal lymph node block dissection

Use of the Anterolateral Thigh and Vertical Rectus Abdominis Musculocutaneous Flaps as Utility Flaps in Reconstructing Large Groin Defects

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