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PubMedDate not supplied

The oblique rat groin flap.

Neovascularisation from the bed can result in the partial survival of failing rat groin flaps. This can interfere with the interpretation of pharmacological augmentation and ischaemia experiments. We describe the development of a modified rat groin flap which utilises the inguinal fat pad to diminish the effects of the bed on the skin component of the flap. The behaviour of this model is compared to that of standard rat groin flaps and flaps which have had polythene sheeting placed under them.

Adipose Tissue↗

PubMed1992

Primary reconstruction to avoid wound breakdown following groin block dissection.

We report our experience of immediate reconstruction of the groin using the deep inferior epigastric artery (DIEA) myocutaneous flap following 32 consecutive ilioinguinal block dissections for groin metastases in patients with penile carcinoma. All groin wounds healed primarily, resulting in a short postoperative hospital stay. Transferring one or both DIEA flaps did not lead to any significant functional disability.

Groin↗

PubMed1992

Hip disarticulation for recurrent vulvar cancer in the groin.

A patient with squamous cell carcinoma of the vulva treated with a radical vulvectomy and bilateral inguinal and femoral lymphadenectomies utilizing separate groin incisions, subsequently developed a recurrence in the skin bridge between the vulvar and groin excisions. Following groin irradiation with chemosensitization, the tumor progressed to involve the superior public ramus and femoral vessels. A left hip disarticulation and resection of a portion of the superior pubic ramus was performed. The patient has been free of disease for 3 years. The advantages of this procedure over a hemipelvectomy include shorter operative time, reduced blood loss, better fascial closure of the abdomen, and the creation of a stump which is more amendable to prosthetic fitting.

Carcinoma, Squamous Cell↗

PubMed1993

Does the addition of pre-operative skin preparation with povidone-iodine reduce groin sepsis following arterial surgery?

Sixty-four consecutive patients undergoing elective vascular surgery involving exposure of the femoral artery at the groin were randomized to one of two groups. Group A (N = 34) received twice-daily skin preparation with 10% aqueous povidone-iodine for 48 h preoperatively, while group B (N = 30) did not. Both groups were examined on a daily basis following surgery and any discharge from the wound was recorded and sent for bacteriological culture. The groups were well matched for age, sex and the type of vascular graft material used. In group A there were six (18.7%) groin wound infections and in group B there were five (17.2%). In this series of patients the addition of preoperative skin preparation with 10% povidone-iodine to standard peri-operative prophylaxis had no effect on the incidence of postoperative groin wound sepsis.

Adult↗

PubMed1993

Capsaicin applied to rat lumbar intervertebral disc causes extravasation in the groin skin: a possible mechanism of referred pain of the intervertebral disc.

Administration of 10 micrograms of capsaicin into the anterior portion of a lumbar intervertebral disc of rats pretreated with Evans blue (i.v.) caused dye extravasation in the groin skin. This phenomenon occurred even when the spinal nerve of the same segment, bilateral sympathetic trunks, and/or the anterior L2 spinal root had been cut; it did not occur in rats with a cut genitofemoral nerve. Infiltration of capsaicin solution directly into the genitofemoral nerve did not cause dye extravasation. These results suggested the presence of dichotomizing sensory C-fibers which innervate both the intervertebral discs and the groin skin in the L2 spinal nerve. If such dichotomizing fibers exist in man, they may contribute to the groin pain sometimes associated with intervertebral disc lesions.

Animals↗

PubMedDate not supplied

Herniography in 79 patients with unexplained pain in the groin: a retrospective study.

To assess the safety and accuracy of herniography for the diagnosis of inguinal hernia in young military men with unexplained pain in the groin, a retrospective study in 79 patients with unexplained pain in the groin who underwent a herniography is presented. Nineteen patients (24%) showed a positive herniogram which was confirmed in 15 out of 16 patients who subsequently underwent surgery. All 60 (76%) patients with a negative herniography were followed-up. An inguinal hernia was subsequently found at surgery in two patients out of eight who were operated on later. In our series no serious complications occurred. Herniography has been shown to be a safe and reliable method to demonstrate or exclude an inguinal hernia in young military men with unexplained pain in the groin. The differential diagnosis in this specific patient group is discussed.

Adolescent↗

PubMed2006

Successful management of recalcitrant groin lymphorrhoea with the combination of intraoperative lymphatic mapping and muscle flap.

Recalcitrant groin lymphorrhoea in high-risk patients remains a problem. In this report, a cardiac transplant patient with recalcitrant groin lymphorrhoea was successfully treated with a combination of intraoperative lymphatic mapping and sartorius muscle flap. We believe that the combined use of these two treatment options offers a more effective approach for surgical treatment of recalcitrant groin lymphorrhoea and should be considered when managing this difficult clinical problem, especially in high-risk patients.

Groin↗

PubMed2006

Reconstruction of wide scrotal defect using superthin groin flap.

INTRODUCTION: Grafts and flaps have been widely used to reconstruct scrotal defects due to Fournier's gangrene. Controversy still exists concerning the use of grafts and flaps because of the low protection provided by the grafts and the high volume of the flaps. We describe the use of an expanded groin flap for scrotum reconstruction. TECHNICAL CONSIDERATIONS: Three patients were treated for total scrotal tissue loss using this method. An expander was installed through an incision from the inferolateral aspect of the groin, and superthin flaps obtained after 3 weeks were dissected starting from the medial side. Care was taken during dissection, because the skin was thin on the lateral side, and dissection was performed in a subfascial fashion. Finally, the defect was covered with the lateral part of the expanded flap and the donor site was primarily closed. CONCLUSIONS: To cover the testes, both the aesthetic and functional state should be taken into consideration. Therefore, a thin and durable cover is required for scrotal reconstruction. The expanded superthin groin flap possesses these features and is a good option.

Adolescent↗

PubMed2006

A vascular graft for endometrial cancer groin recurrence.

BACKGROUND: Recurrent groin metastases from endometrial cancer that invades the femoral vasculature is debilitating and provides a management dilemma. CASE: We present the first case of endometrial cancer with metastatic disease to the groin vasculature palliated with percutaneous endovascular embolization and stent grafting. CONCLUSION: Endovascular surgery provides an alternative option in those with metastatic endometrial cancer of the groin to improve the patient's quality of life by avoiding a major surgery with difficult postoperative recovery and prolonging the timecourse until the next major bleed.

Aged↗

PubMed1990

Sartorius myoplasty for deep groin wounds following vascular reconstruction.

Groin wound infections following vascular reconstructive surgery prolong hospital admission and convalescence and may lead to more serious morbidity with prosthetic graft infection, false aneurysm formation, or hemorrhage. Therefore, it is imperative to achieve wound closure as expeditiously as possible. Herein, we describe 11 patients with complicated groin wounds and report our management using sartorius myoplasty. Five of these patients had underlying prosthetic grafts at risk. All patients underwent wound closure with sartorius myoplasty after adequate debridement of necrotic and infected soft tissue. Success of wound closure with complete primary healing was observed in nine patients, while in two, adequate early coverage of femoral vessels was achieved, but extended wound care for superficial skin separation was necessary with eventual complete healing. There was no morbidity or mortality related to the added surgical procedure. One patient underwent late repair of a femoral false aneurysm. There were no other complications seen after an average follow-up of 20 months (range: 6 to 49 months). In summary, we recommend that sartorius myoplasty be considered for wound infections to hasten groin closure, decrease hospital stay, and reduce the chance of infectious complications.

Adult↗

PubMed1998

Groin hernia and surgical truth.

BACKGROUND: Surgeons have used many methods to repair groin hernia since 1889. In that year, both Halsted and Bassini described the first effective operation. All operative solutions to groin hernia since then have used a suture repair. The differences have been related to the anatomic structures that are joined by the sutures. Recently, laparoscopy has forced most surgeons to question their approach to groin hernia. Common questions are: Is laparoscopy superior? When should mesh be used? Which of the many available techniques give superior results? DATA SOURCES: This review presents an opinion-based review of the classical and recent literature. In addition, this review considers the manner in which surgeons search for answers to such questions. CONCLUSION: The result of this search, for the author, is an acceptance of the mesh plug repair as superior to all others currently available.

Decision Making↗

PubMed2000

Resurfacing deep wound of upper extremities with pedicled groin flaps.

A total of 29 axial pedicled groin skin flaps were applied clinically with satisfactory result excepting for one flap which tailed on transplantation. These cases included severe scar contracture of the dorsum of hands in 20 patients, deeply burned wounds with infection and exposure of deep structure in upper extremities in nine patients, such as electrical burns and hot-crushing injuries. The flap is supplied by two groups of nutrient vessels with abundant vascularization and located in a hidden area. Therefore, the pedicled groin skin flap is still valuable due to its advantages as safe, easy operation and strong antiinfective ability although the free groin flap is more widely used today.

Adult↗

PubMed1997

Lower extremity salvage after radical resection of malignant tumors in the groin and lower abdominal wall.

BACKGROUND: Resection of a large malignant tumor in the groin often leaves a substantial soft-tissue defect that makes wound closure difficult. Nevertheless, palliation and lower extremity salvage is frequently possible if the tumor is widely excised and the wound closed with well-vascularized tissue; however, few data are available on patients undergoing such procedures. STUDY DESIGN: We retrospectively examined our experience with limb salvage in 25 patients undergoing radical groin resection for metastatic or recurrent malignant tumors between April 1, 1991 and April 8, 1996. RESULTS: Defect size ranged from 15 to 735 cm2 (mean, 238.5 cm2). Tumor resection included part of the abdominal wall in 14 patients and the femoral vessels in 5 patients. Defects were most commonly repaired with a vertical rectus abdominis myocutaneous flap (56%). Mean hospital stay was 10.4 days, and mean followup was 15.5 months. Although the complication rate was 68%, the limb salvage rate was 100%, and normal ambulation was achieved in 88% of patients. The most frequent complications were chronic lymphedema (42%) and seroma (29%). There was one perioperative death (4%). CONCLUSIONS: Functional limb salvage after radical resection of the groin and lower abdominal wall is very successful, has an acceptable morbidity rate, does not prolong hospital stay, and contributes significantly to the patient's quality of life. Chronic lymphedema is a frequent complication after this treatment but can be managed successfully with conservative techniques.

Abdominal Muscles↗

PubMedDate not supplied

Treatment of periprosthetic soft tissue infection of the groin following vascular surgical procedures by means of a polyvinyl alcohol-vacuum sponge system.

Deep groin infections after prosthetic vascular surgical procedures represent a serious complication of surgical practice. Septicemia and/or erosive hemorrhage can both be consequences. In this situation, removal of the graft appears to be the only option. However, if the infection is detected early (type Szilagyi III), local treatment to eradicate the infection could serve as an alternative. Twenty-four patients with confirmed infection of the soft tissue adjacent to the prosthetic material in the groin were treated locally by implantation of a vacuum sponge system. Duration of this treatment was 2 weeks. All patients showed excellent tissue granulation of the wound area and the microbial stains were negative at the end of therapy. In 21 patients the wound could be primarily closed after explantation of the sponge. Three patients underwent open treatment because of a skin defect. After 12 months, the wounds had healed well in all patients. Histologic evaluation revealed a physiological healing process. Deep soft tissue infections of the groin adjacent to prosthetic vascular material (type Szilagyi III) can be treated effectively and safely with the vacuum sponge system. The treatment is inexpensive, easy to perform, and the initial vascular reconstruction can be preserved.

Aged↗

PubMed2002

Groin exploration for nonpalpable testes: laparoscopic approach.

PURPOSE: Diagnostic laparoscopy (DL) is the technique of choice for exploration of nonpalpable testes (NPT). Nevertheless, groin exploration is necessary to evaluate the cord and gonadal structures entering the internal ring. This retrospective analysis evaluates our hypothesis that hypoplastic cord structures entering the internal ring predicts absence of a viable testicle and a laparoscopic groin exploration in these cases can reduce the number of unnecessarily performed open groin exploration (OGE). MATERIALS: A retrospective review was performed of 23 boys with 26 NPTs who were operated on from June 1998 to October 2000 to evaluate our protocol for NPT using DL and OGE. RESULTS: Of 26 NPTs in 23 boys, 3 bilateral intraabdominal testis were detected (2 Fowler Stephens; 1 standard orchidopexy). Twenty cord structures entered the internal ring. Three appeared normal at DL with a viable testis followed by an orchidopexy. Seventeen were hypoplastic without patent processus. During LGE no viable testis was detected: blind-ending cords, no biopsy (n = 4); testicular regression syndromes (n = 3), early fetal regression (n = 6), no residual testicular structures (n = 4). CONCLUSIONS: This experience confirms the authors' hypothesis and criteria for LGE in all cases. The authors conclude that LGE is a helpful tool in the diagnostic workup of NPT to avoid unnecessary OGE and is a further step in the minimally invasive approach to all kinds of findings of NPT.

Adolescent↗

PubMed2006

MR imaging of groin pain in the athlete.

Groin pain is a frequently encountered symptom in the athlete. The differential diagnosis for an athlete presenting with groin pain is broad and diagnostic imaging plays a crucial role in reaching the correct diagnosis, allowing appropriate therapy to be instituted. In this article we present the radiological differential diagnosis of athletes presenting with groin pain. The common mechanisms of injury, presenting symptoms, and imaging findings for each of these entities are addressed.

Athletic Injuries↗

PubMed1991

Free groin flaps in microsurgical reconstruction of the extremity.

The authors performed free groin flap transplantation in 36 patients with extensive soft-tissue injury of the extremities. In each case, the vascular anatomy of the groin flap was analyzed during the operation. The anatomic classification of the superficial circumflex iliac artery according to its origin was as follows: a common origin with the superficial inferior epigastric artery in 15 cases (39.5 percent); an isolated origin and absent superficial inferior epigastric artery in 14 cases (36.8 percent), a separate origin in three cases (7.9 percent), and an origin from the profunda femoral artery in six cases (15.8 percent). These results are similar to those reported previously. The overall success rate was 72.2 percent. The success rate was better in the upper extremity (100.0 percent) than in the lower extremity (65.5 percent). Free vascularized groin flap transplantation is a suitable procedure for the one-stage reconstruction of severe soft-tissue injury, especially in the upper extremity.

Arm Injuries↗

PubMed1985

Femorofemoral bypass with an infrascrotal perineal approach for the patient with an infected groin wound.

A technique is presented for revascularization of patients having a groin wound infection, which minimizes the risk of recurrent graft infection. A femorofemoral bypass with a subcutaneous perineal tunnel is constructed farther from the infected groin wound than the standard subcutaneous suprapubic tunnel. The route of the graft appears to result in neither excessive tension on the graft when the leg is abducted nor kinking of the graft when the leg is adducted. Long-term follow-up will be needed to compare the patency of this route with the standard suprapubic tunnel in patients with an infected groin wound who require a femorofemoral bypass graft.

Arterial Occlusive Diseases↗