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Original Article Plastic and Aesthetic Research

Superiorly based perforator plus fl ap for

inguinal defects

Pradeoth Mukundan Korambayil, Prashanth Varkey Ambookan, Vinoth Kumar Dilliraj
Department of Plastic Surgery and Burns, Jubilee Institute of Surgery for Hand, Aesthetic and Microsurgery, Jubilee Mission Medical
College and Research Institute, Thrissur 680005, Kerala, India.
Address for correspondence: Dr. Pradeoth Mukundan Korambayil, Flat No. 102, Nandana, Haritha Gardens, Vadookara, Thrissur 680007,
Kerala, India. E-mail: pradeoth@gmail.com

ABSTRACT
Aim: Inguinal block dissections for metastasis to inguinal lymph nodes and occasionally trauma
are always associated with soft tissue loss over the groin region. A clinical study was undertaken
to demonstrate the ability to utilize a superiorly-based perforator fl ap with reliable vascularity and
less donor site morbidity to cover defects in the inguinal region. Methods: A prospective study was
performed on 7 patients with inguinal soft tissue defects managed in our institution from January
2013 to September 2013. During the study period, a ”superiorly-based perforator plus fl ap” was used
for soft tissue coverage over the femoral vessels in the inguinal region. Hyperbaric oxygen therapy
was administered postoperatively. The postoperative period, hospital course, and follow-up after
radiotherapy was documented in patients with inguinal block dissection. Results: Seven patients
presented with soft tissue defects in the inguinal region. Five of the defects were secondary to prior
surgery, and 2 were secondary to trauma. A superiorly-based perforator plus fl ap was performed in
all patients. The defect sizes ranged from 9 cm × 4 cm to 17 cm × 8 cm. The fl ap dimensions ranged
from 12 cm × 5 cm to 20 cm × 10 cm. No secondary procedures were necessary following surgery.
Postoperatively, there was no evidence of partial or total fl ap loss. No fl ap revisions were required, and
no complications were experienced at either the donor or recipient site following radiotherapy. Patients
were followed-up for 10-18 months. Conclusion: Inguinal defects require stable soft tissue coverage
to withstand radiotherapy following inguinal block dissection surgery, and are susceptible to wound
complications. The superiorly-based perforator plus fl ap technique is simple, requires little operative
time, and is a reliable fl ap for coverage of the femoral vessels and inguinal region with improved
tolerance to postoperative radiotherapy.
Key words:
Hyperbaric oxygen therapy, inguinal lymph nodes, soft tissue defect, superiorly-based perforator plus flap

INTRODUCTION following inguinal block dissections. Occasionally,
trauma may also result in a soft tissue defect in these
Inguinal block dissections are commonly performed for regions. Morbidity can be reduced by providing a bulky,
skin malignancies of the lower limb and genital regions. vascularized flap to the inguinal soft tissue defect, which
Wound complications including skin necrosis, infection, provides coverage to the femoral vessels, obliterates
lymphorrhea, and lymphedema are not uncommon the dead space, and promotes healing. Reconstructive
options currently available for soft tissue defects in the
Access this article online inguinal region include the tensor fascia lata (TFL) flap,
Quick Response Code: the anterolateral thigh flap, and the rectus abdominis
Website: flap. We present a “superiorly-based perforator plus
www.parjournal.net
flap” which provides stable soft tissue coverage over the
femoral vessels, reduces the risk of wound dehiscence
and lymphatic drainage problems, improves tolerance to
DOI:
10.4103/2347-9264.143551 radiotherapy, and decreases the incidence of donor site
morbidity when compared to other flaps.

Plast Aesthet Res || Vol 1 || Issue 3 || Dec 2014 89