AN OBLIQUELY DESIGNED MODIFIED GROIN FLAP: SOLVING THE PROBLEM OF CLOSING LARGE DONOR SITE DEFECT

Abstract

Objectives: The Aim of this study was to assess the outcomes of patients with soft tissue defects of hand and forearm reconstructed by an obliquely designed modified pedicled groin flap. Methodology: A prospective cross-sectional study was conducted in the Department of Plastic Surgery, CMH Rawalpindi, over a three-month period. A total of 105 patients aged 18–60 years with large soft tissue defects of the hand or forearm requiring groin flap reconstruction were enrolled through consecutive non-probability sampling. Patients with conditions affecting wound healing were excluded. Demographic and clinical variables were recorded, and all procedures were performed by experienced plastic surgeons following standardized protocols. Patients were followed for 30 days postoperatively to assess flap survival, flap loss, infection, donor site wound dehiscence, and hematoma formation. Data were analyzed using SPSS version 22, and associations between risk factors and wound dehiscence were evaluated using Chi-square or Fisher’s exact tests. Results: The mean age of participants was 34.8 ± 10.6 years, and 81.0% were male. Road traffic accidents were the most common cause of injury (38.1%). Successful flap survival was achieved in 92 patients (87.6%). Partial flap loss occurred in 7.6%, complete flap loss in 4.8%, flap-site infection in 11.4%, wound dehiscence in 9.5%, and hematoma formation in 6.7% of patients. Smoking status (p=0.018) and larger defect size (>100 cm²) (p=0.032) were significantly associated with wound dehiscence. Conclusion; An obliqeuly designed modified pedicled groin flap reconstruction is a safe and effective technique for managing large hand and forearm soft tissue defects, demonstrating high flap survival and acceptable complication rates. Smoking and larger defect size >80cm is significant predictors of wound dehiscence and should be considered during patient selection and perioperative management.