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dimension ranging from 12 cm × 5 cm to 20 cm × 10 cm and ilio-inguinal block dissection with resection of the
were created. There was no need for any secondary involved inguinal skin and soft tissues was performed
procedures following surgery. Drains were removed [Figure 2a]. A plan was made for reconstruction of the
between 4 and 7 days and sutures were removed on the [Figure 2b] soft tissue defect over the exposed femoral
14th–17th postoperative day. Postoperatively, there was vessels in the inguinal defect. The superiorly-based
no evidence of either partial or total flap loss. No flaps perforator plus flap was performed [Figure 2c and d],
required revision, and no fat necrosis was noted. There allowing coverage of the defect and primary closure of
were no flap complications or donor site morbidity the donor site defect. Postoperatively, six sessions of
following radiotherapy [Table 1]. Patients were followed hyperbaric oxygen therapy were administered. The flap
for 10–18 months after surgery. During this period, there healed well [Figure 2e and f]. Regular follow-up was
was no recurrence of the tumor in the case of patients performed. The flap tolerated radiotherapy well.
who had undergone inguinal block dissection.
Patient with fungating right-sided inguinal lymph
Patient with squamous cell carcinoma of the left leg nodes
A 58-year-old male patient presented with squamous cell A 48-year-old male patient presented with fungating
carcinoma of the left leg. Multiple inguinal lymph node inguinal lymph nodes on the right side. He had previously
were involved and were adherent to each other and to undergone surgery for squamous cell carcinoma of
the overlying skin. Wide excision of the primary lesion
the right foot and received radiotherapy to the right
inguinal region. A palliative inguinal block dissection
Table 1: The patients treated using superiorly based was performed [Figure 3a]. The inguinal defect was
perforator plus fl aps for inguinal soft tissue defect covered with a superiorly-based perforator plus flap
Age in Diagnosis Flap dimensions [Figure 3b and c]. Postoperatively, six sessions of hyperbaric
years/sex length × width at oxygen therapy were administered. The flap healed well.
base (cm × cm)
59/male Squamous cell carcinoma of 20 × 10 Patient with soft tissue defect over the inguinal
left leg with multiple inguinal LN region
8/female Soft tissue defect due to trauma 12 × 5 An 8-year-old female child was involved in a road traffic
with defect of 9 cm × 4 cm right accident, resulting in a soft tissue defect over the inguinal
groin region
42/male Squamous cell carcinoma of left 18 × 9 region [Figure 4a and b]. The patient was stabilized, and
foot with multiple inguinal LN debridement was performed [Figure 4c]. The resulting
48/male Squamous cell carcinoma right 18 × 10 soft tissue defect was covered with a superiorly-based
foot with fungating inguinal LN perforator plus flap [Figure 4d and e]. Postoperatively, six
52/male Carcinoma penis with right side 16 × 8 sessions of hyperbaric oxygen therapy were administered,
inguinal LN and the flap healed well [Figure 4f and g].
56/female Carcinoma ovary with ilio 19 × 9
inguinal LN
27/male Soft tissue defect due to trauma 15 × 6 DISCUSSION
with defect of 14 cm × 6 cm
right groin region Lymph node involvement is an important prognostic
LN: Lymph nodes marker in primary skin appendage tumors, melanomas

a b c

d e f
Figure 2: The patient with squamous cell carcinoma of the left leg. (a) Soft tissue defect inguinal region following dissection; (b) planning of superiorly-
based perforator plus flap; (c) immediate postoperative view of the superiorly-based perforator plus flap lateral view; (d) immediate postoperative
lateral view to show primary closure of donor defect; (e) late postoperative picture after 1 month; (f) late postoperative picture after radiotherapy

Plast Aesthet Res || Vol 1 || Issue 3 || Dec 2014 91