The Mcgregor Pedicled Groin Flap for Hand Skin Defects
Main Article Content
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.
Article Details
This work is licensed under a Creative Commons Attribution 4.0 International License.
References
I. Altuntas, S. H., Dilek, O. F., Gurdal, O., Uslusoy, F., & Aydin, M. A. (2023). The Use of Groin Flap for Hand Defects: Which Should Be Prior, Free or Pedicled, Based on Patient-Reported Outcomes?. Selcuk University Medical Journal, 39(3).
II. Devarasetty, V. M., Vickery, J. W., & Maslow, J. I. (2024). Outcomes of Pedicled Groin Flaps for Upper Extremity Injuries. HAND, 15589447241265520.
III. Barry, L., Guerre, E., Jeanne, M., & Pasquesoone, L. (2024). The Place of Groin, Colson and McGregor Flaps in the Acute Care of Deep Burns to the Hand Dorsum: A Series of 6 Cases In Lille's Burn Centre. Annals of Burns and Fire Disasters, 37(1), 64-78.
IV. Sharma, R., Dogra, K. S., Rayaz, M., & Gupta, S. (2021). Abdominal Flaps in Coverage of Forearm and Hand Defects. JK Science: Journal of Medical Education & Research, 23(3), 138-143.
V. Wagner, R. D., Carr, L., & Netscher, D. T. (2020). Current indications for abdominal-based flaps in hand and forearm reconstruction. Injury, 51(12), 2916-2921.
VI. Adeel, I., Ali, G., Mirza, T. I., & Malik, M. J. (2021). Groin Flap; A Simple and Versatile Option for Coverage of Hand Defects. In Medical Forum Monthly (Vol. 32, No. 4).
VII. Venkatramani, H., Zargaran, D., Nikkhah, D., Ruston, J., & Sabapathy, S. R. (2023). The Groin Flap: The Workhorse Flap for Upper Limb Reconstruction. In Core Techniques in Flap Reconstructive Microsurgery: A Stepwise Guide (pp. 313-323). Cham: Springer International Publishing.
VIII. Orozco-Grados, J. D. J., Cordova, J. C., Garcia, J. A. G., Armenta, D. Y. B., Gonzalez, A. A., & Galvis, D. C. (2023). Groin Flap for Reconstruction of Traumatic Degloving Hand Injury: A Report of 5 Cases. World Journal of Plastic Surgery, 12(1), 63.
IX. Barry, L., Guerre, E., Jeanne, M., & Pasquesoone, L. (2024). The Place of Groin, Colson and McGregor Flaps in the Acute Care of Deep Burns to the Hand Dorsum: A Series of 6 Cases In Lille's Burn Centre. Annals of Burns and Fire Disasters, 37(1), 64-78.