Tensor fascia lata flap reconstruction following groin dissection: is it worthwhile?
Summary of "Tensor fascia lata flap reconstruction following groin dissection: is it worthwhile?"
OBJECTIVE:
To compare the morbidity of primary skin closure with elective Tensor Fascia Lata (TFL) flap cover in groin dissections. MATERIALS AND
METHODS:
This was a retrospective study between January 2007 and December 2009. All patients undergoing groin dissections without skin involvement were included.
RESULTS:
Of the twenty-five patients, who underwent groin dissections, 14 had primary skin closure (28 groin dissections)-group I. Eleven had TFL flap cover as a means of primary reconstruction (20 groin dissections)-group II. In group I, there were 16 (57%) inguinal dissections and 12 (43%) ilioinguinal block dissections, whereas 82% in group II underwent ilioinguinal dissections (p = 0.09). Wound infection requiring treatment with a culture specific antibiotic was required in 4 (14%) in group I (n = 28) and only 1 (5%) in group II (n = 20) (p = 0.38). In group I, 7 (25%) had major flap necrosis and minor necrosis was seen in another 7 (25%). Only three (15%) in group II developed minor flap necrosis (p = 0.01). Following an ilioinguinal dissection, flap necrosis occurred in 75% of groins that underwent primary closure and in 17% of those which were reconstructed with TFL (p = 0.001). Seroma formation was seen in 5 (18%) in group I and 3 (15%) in group II (p = 1.0). Lymphoedema occurred in equal numbers in both groups. The duration of hospital stay was 20 ± 14 days in the primary closure group and 16 ± 3 days in the TFL group.
CONCLUSION:
The TFL flap can reduce postoperative morbidity and decrease hospital stay. Prophylactic TFL flap reconstruction following ilioinguinal dissections is advisable.
Affiliation
Department of Urology, Christian Medical College, Vellore, Tamil Nadu, 632004, India, nirmaltj@gmail.com.
Journal Details
This article was published in the following journal.
Name: World journal of urology
ISSN: 1433-8726
Pages:
Links
- PubMed Source: http://www.ncbi.nlm.nih.gov/pubmed/21626446
- DOI: http://dx.doi.org/10.1007/s00345-011-0706-z
Medical and Biotech [MESH] Definitions
Keratomileusis, Laser In Situ
A surgical procedure to correct MYOPIA by CORNEAL STROMA subtraction. It involves the use of a microkeratome to make a lamellar dissection of the CORNEA creating a flap with intact CORNEAL EPITHELIUM. After the flap is lifted, the underlying midstroma is reshaped with an EXCIMER LASER and the flap is returned to its original position.
Flap Endonucleases
Endonucleases that remove 5' DNA sequences from a DNA structure called a DNA flap. The DNA flap structure occurs in double-stranded DNA containing a single-stranded break where the 5' portion of the downstream strand is too long and overlaps the 3' end of the upstream strand. Flap endonucleases cleave the downstream strand of the overlap flap structure precisely after the first base-paired nucleotide, creating a ligatable nick.
Neck Dissection
Dissection in the neck to remove all disease tissues including cervical LYMPH NODES and to leave an adequate margin of normal tissue. This type of surgery is usually used in tumors or cervical metastases in the head and neck. The prototype of neck dissection is the radical neck dissection described by Crile in 1906.
Keratectomy, Subepithelial, Laser-assisted
A surgical technique to correct REFRACTIVE ERRORS of the EYE, such as MYOPIA and ASTIGMATISM. In this method, a flap of CORNEAL EPITHELIUM is created by exposure of the area to dilute alcohol. The flap is lifted and then replaced after laser ablation of the subepithelial CORNEA.
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