The Mcgregor Pedicled Groin Flap for Hand Skin Defects

Abstract

The groin flap is a surgical method used to cover soft tissue defects in the hand and forearm, such as wounds, traumatic amputations, degloving injuries, burns, burn scar release, and tumor excision. It is effective in covering extensive and intricate defects, such as wounds, traumatic amputations, degloving injuries, burns, burn scar release, and tumor excision. The procedure involves a remote autoplasty supported by the vascular territory of the superficial iliac circumflex artery. The flap's boundaries are defined using the "2 fingers width" criterion, and the flap is raised from lateral to medial, transferring subcutaneous tissue while keeping it above the fascia. The flap is closed using drain suction, and the patient is allowed to walk on the 5th day after surgery. Effective preoperative planning is essential for preventing the creation of too big or too tiny flaps and ensuring the fabrication of appropriate tubing to avoid complications. The McGregor groin flap is a commonly used technique for hand deformity reconstruction due to its extended pedicle and quick execution. It is adaptable, repeatable, and can be performed by less-experienced surgeons without microsurgery expertise. The flap covers significant tissue loss with pliable tissue, making it suitable for joints. It can cover abnormalities on the back or palm, and can be used for early wrist and hand rehabilitation. However, it has drawbacks, such as shoulder stiffness in older patients, discomfort during the upper limb positioning, and the need for multiple phases. Despite these, the groin flap remains relevant in the age of microsurgery and can be improved with technical modifications.