Free Microdissected Thin Groin Flap Design with an Extended Vascular Pedicle

Abstract

The uniform thinness and long vascular pedicle are distinctive characteristics of this flap compared with the traditional groin flap. Moreover, the buried vessels in the deep adipose layer and fascia can be confirmed by microdissection; this enables prediction of the safe area of the flap.

A Case of Harvesting Anterolateral Thigh Flaps Twice from the Ipsilateral Thigh of a Single Patient in Separate Operations

“…In other flaps, such as a deep inferior epigastric artery perforator flap [3], a thoracodorsal artery perforator flap [4], and a tensor fasciae latae perforator flap [5], the perforators are too closely located to each other to allow elevation of the two flaps. Moreover, a groin flap has one dominant perforator [6], so it can-not provide two flaps. Accordingly, the anterolateral thigh flap is the only perforator flap that can be used for double flap harvesting from a single donor site.…”

Super-Thinned Iliac Flap for Major Defects on the Elbow and Wrist Flexion Creases

“…1,19,20 The deep branch continues laterally deep on the groin. Close to the medial border of the sartorius fascia, the deep branch usually gives off a medial cutaneous branch 1,3,7,8,10,19 and progresses by perforating the medial edge of the sartorius fascia. On its way, it irrigates this muscle and ends perforating the fascia laterally and sending a branch (lateral branch) to the skin, named by Koshima et al the "iliac perforating branch."…”

“…1,19,20 The superficial branch goes directly to the skin and may play a major role in the blood supply of the iliac flap. 1,19,20 The deep branch continues laterally deep on the groin.…”

“…1,19,20 The superficial branch goes directly to the skin and may play a major role in the blood supply of the iliac flap. 1,19,20 The deep branch continues laterally deep on the groin. Close to the medial border of the sartorius fascia, the deep branch usually gives off a medial cutaneous branch 1,3,7,8,10,19 and progresses by perforating the medial edge of the sartorius fascia.…”

“…18 The iliac flap combines the advantages of a naturally thin flap with a long pedicle and minimal donor-site morbidity. Furthermore, the dermis is much thinner than that of other possible thinned skin flaps (such as the lateral thigh or scapular) 19 making it ideal for adaptation to flexion creases. From a personal experience of 21 consecutive free iliac flaps, 4 were used to treat or prevent flexion contracture at the elbow (3 cases) or the wrist (1 case) and are the subject of this article.…”