Outcomes of Pedicled Tubed Groin Flaps in Coverage of Circumferential Degloving Skin Loss of Fingers

Document Type : Original Article

Authors

The Plastic Surgery Unit, General Surgery Department, Faculty of Medicine, Benha University

Abstract

Background: Avulsion of skin from the hand or fingers
is an injury that has a dramatic presentation with significant
challenge in reconstructive surgery due to the hand’s intricate
anatomy and essential functional role. One of the main considerations
in fingers reconstruction is the choice of an appropriate
flap. Among the various flaps used in hand reconstruction,
the pedicled groin flap has gained significant attention.
Objectives: The purpose of this study is to assess outcomes
of groin pedicled tubed flaps as a method of reconstruction
of circumferential degloving skin of fingers in terms of
flap survival, sensibility, range of motion, aesthetic outcomes
and wrist functions after flap separation.
Subjects and Methods: This study was conducted on 20
patients who were recruited from the emergency room in
Benha University Hospital presented during the period from
September 2023 to September 2024 with finger’s circumferential
degloving skin loss, Urbaniak class III and were treated by
tubed groin flap. Assessment of the postoperative wrist, elbow
and shoulder function according to DASH score questionnaire,
flap survival, sensibility, range of motion, aesthetic outcomes.
Results: There were 15 (75%) males and 5 (25%) females,
their age ranged from 28-53 years. 13 cases (65%) presented
after motor vehicle accidents, 4 cases (20%) after industrial
accidents and 3 cases (15%) with avulsion injury. The duration
of surgery ranged from 2-2.5 hours, and duration of treatment
till complete healing of hand and groin wounds ranged from
42-77 days. Only 1 case (5%) had flap failure, marginal flap < br />Necrosis happened in 2 cases (10%), groin wound infection in
1 case (5%).
Conclusion: This study demonstrated the efficacy of tubed
Groin flaps in the reconstruction of circumferential skin loss of
fingers, which simple procedure, easy to be learnt, and short operative time
duration and minimal effect on wrist function.

Keywords

Main Subjects

References

Höllwarth M.E.: Soft Tissue Trauma. In: Pediatric Surgery:
General Pediatric Surgery, Tumors, Trauma and
Transplantation. Springer, p. 735-743, 2021.
2- Hamouya A., Barbato B., Beauthier-Landauer V. and
Hémon C.: Complete ring finger avulsion: Review of 16
years of cases at a Hand Emergency Unit. Hand Surg. Rehabil,
2018.
3- Kadry H.M., El Sharkawy O., El Essawy N. and Taha
A.A.: Back to Groin; Re-Knocking the Door…. The Egyptian
Journal of Plastic and Reconstructive Surgery, 44 (4):
487-94, 2020.
4- Mishra J.K., Sahu S.A., De M., et al.: Pedicled anterolateral
thigh flap: A versatile flap for complex regional defect
reconstruction. GMS Interdiscip Plast. Reconstr. Surg.
DGPW, 12, 2023.
5- Jabaiti S., Ahmad M. and AlRyalat S.A.: Reconstruction
of upper extremity defects by random pedicle abdominal
flaps: Is it still a valid option? Plast Reconstr Surg. Glob.
Open., 8 (3), 2020.
6- Goertz O., Kapalschinski N., Daigeler A., et al.: The effectiveness
of pedicled groin flaps in the treatment of hand
defects: Results of 49 patients. J. Hand Surg. Am., 37 (10):
2088- 94, 2012.
7- Liu H., Guo T., Wang B., Wu F., Zhang W., Xu T., et al.: A
two-stage surgery for completely degloving injury of multiple
fingers: A retrospective cohort study. Journal of Hand
and Microsurgery, 100151, 2024.
8- Smith P.J., Foley B., McGregor I.A., et al.: The anatomical
basis of the groin flap. Plast. Reconstr. Surg., 49: 41-7,
1972.
9- Amouzou K.S., Berny N, El Harti A., et al.: The pedicled
groin flap in resurfacing hand burn scar release and other
injuries: A five-case series report and review of the literature.
Ann Burns Fire Disasters, 30 (1): 57-61, 2017.
10- Acharya A.M., Ravikiran N., Jayakrishnan K.N., et al.:
The role of pedicled abdominal flaps in hand and forearm
composite tissue injuries: Results of technical refinements
for safe harvest. J. Orthop., 16 (4): 369-376, 2019.
11- Jacobson L., Skladman R., Tuggle C.T., et al.: Pedicled
groin flap for reconstruction of combined first webspace
and dorsal hand contracture. Eplasty, 22, 2022.
12- Romana Parvin1*, Mohd Fazle Rubby2 and Mohammad
Abul Kalam Azad3, MD.: Toriqul Islam4 and MD Shahidul
Islam Farhad5: “Groin Flap” for Reconstruction of
Defects on Dorsum of the Hand. Annals of International
Medical and Dental Research E-ISSN: 2395-2822 |
P-ISSN: 2395-2814 2021.
13- Wael Ayad, Gamal Ibrahim El-Habaa, Emad Eldeen Mostafa
Abdelhafez, Mostafa Saeed Abdeen, Ola Ahmed Seif
and Ahmed Abdelrahim Shoulah: Egypt, J. Plast. Reconstr.
Surg., Vol. 48, No. 2, April: 99-109, 2024.
14- Krishnamoorthy R. and Karthikeyan G.: Indian Journal of
Plastic Surgery May-August Vol 44 Issue 2, 2011.
15- Imran Adeel, Ghazanfar Ali, Tahir Iqbal Mirza and Muhammad
Jalil Malik: Med. Forum, Vol. 32, No. 4 95 April,
2021.
16- Zyluk A.: Outcomes of coverage of the soft tissue defects
in the hand with a groin flap; Pol Przegl Chir., 95 (2): 32–
38, 2023.
17- PFISTER G., RANC C. and MATHIEU L.: Delayed management
of a ring finger injury by a thinned and tubed
groin flap in a forward surgical unit BMJ Mil Health, 170:
82-83, 2024.

Files

Share

How to cite

Statistics