COVERING
LARGE GROIN DEFECTS WITH THE TENSOR FASCIA LATA MUSCULOCUTANEOUS FLAP
By H. LOUIS HILL, M.D., RODERICKHESTER, M.D. and FOAD NAHAI, M.D. Division of Plastic and Reconstructive Surgery, Emory University, Atlanta, Georgia, USA
DURING the past 2 years we have used the tensor fascia lata muscle with its overlying skin as a musculocutaneous unit to cover ischial and trochanteric defects and as a free flap to cover leg ulcers (Hill et al., 1978). As the following 2 cases illustrate, it is also a useful transposition flap to resurface defects in the groin. CASE REPORTS Case I. This 5o-year-old woman had a g x g cm firm mass in her proved to be a well differentiated leiomyosarcoma, probably of blood excised radically with a 5 cm margin of healthy skin, the deep fascia and dissection. The femoral vessels were protected by shifting the sartorius the defect closed with a neighbouring tensor fascia lata musculocutaneous defect was closed directly (Figs. I - 4).
left inner thigh which vessel origin. It was an in-continuity groin muscle over them and flap. The secondary
Case 2. A 57-year-old man with a carcinoma of his penis had had the penis amputated and a left groin dissection carried out. The groin wound became infected and burst open I week later when he was referred for plastic surgical repair (Fig. 5). When the wound was clean and the infection subsided, the defect was closed with a tensor fascia lata flap (Figs. 6 and 7).
FIG. I.
Case I.
A and B. Operative plan. The tumour mass was cleared by 5 cm all round. tensor fascia lata musculocutaneous flap is outlined.
Address for reprints: H. Louis Hill, Jr., M.D., Atlanta, Georgia 30322, USA.
Emory University 12
The
Clinic, 1364 Clifton Road, N.E.,
COVERING
Frc.
2.
Case
I.
The
defect
prior
FIG. 3.
FIG. 4. Frc.
5,
Case 2.
The
GROIN
I.
I.
The
The musculocutaneous
The secondary
skin defect
following
defect
‘3
DEFECTS
to transposition of the flap. covered by the sartorius.
Case
Case
LARGE
exposed
femoral
vessels
flap transposed
was closed
dehiscence
directly.
of a block
dissection
wound.
were tiryr
I4
BRITISH
FIG. 6. Case
2.
JOURNAL
OF PLASTIC
SURGERY
The musculocutaneous flap raised and ready for transposition, FIG. 7. Case 2. Final closure. COMMENT
From our experience of over 50 cases, there is no doubt that the tensor fascia lata with its overlying skin may be reliably raised on its major pedicle in dimensions of up to 15 x 30 cm. Transposed into nearby groin defects it supplies well vascularised tissue into areas which are notoriously slow to heal. When the femoral vessels are exposed it has the added advantage of providing muscular protection. Special appreciation to Dr MauriceJ.Jurkiewicz support and encouragement.
and Dr Luis 0.
Vasconez for their continued
REFERENCE HILL, H. L., NAHAI, F. and VASCONEZ,L. 0. (1978). The tensor fascia lata myocutaneous free flap. Plastic and Reconstructive Surgery, 61, 517.
LARGE GROIN DEFECTS WITH THE TENSOR FASCIA LATA MUSCULOCUTANEOUS FLAP
By H. LOUIS HILL, M.D., RODERICKHESTER, M.D. and FOAD NAHAI, M.D. Division of Plastic and Reconstructive Surgery, Emory University, Atlanta, Georgia, USA
DURING the past 2 years we have used the tensor fascia lata muscle with its overlying skin as a musculocutaneous unit to cover ischial and trochanteric defects and as a free flap to cover leg ulcers (Hill et al., 1978). As the following 2 cases illustrate, it is also a useful transposition flap to resurface defects in the groin. CASE REPORTS Case I. This 5o-year-old woman had a g x g cm firm mass in her proved to be a well differentiated leiomyosarcoma, probably of blood excised radically with a 5 cm margin of healthy skin, the deep fascia and dissection. The femoral vessels were protected by shifting the sartorius the defect closed with a neighbouring tensor fascia lata musculocutaneous defect was closed directly (Figs. I - 4).
left inner thigh which vessel origin. It was an in-continuity groin muscle over them and flap. The secondary
Case 2. A 57-year-old man with a carcinoma of his penis had had the penis amputated and a left groin dissection carried out. The groin wound became infected and burst open I week later when he was referred for plastic surgical repair (Fig. 5). When the wound was clean and the infection subsided, the defect was closed with a tensor fascia lata flap (Figs. 6 and 7).
FIG. I.
Case I.
A and B. Operative plan. The tumour mass was cleared by 5 cm all round. tensor fascia lata musculocutaneous flap is outlined.
Address for reprints: H. Louis Hill, Jr., M.D., Atlanta, Georgia 30322, USA.
Emory University 12
The
Clinic, 1364 Clifton Road, N.E.,
COVERING
Frc.
2.
Case
I.
The
defect
prior
FIG. 3.
FIG. 4. Frc.
5,
Case 2.
The
GROIN
I.
I.
The
The musculocutaneous
The secondary
skin defect
following
defect
‘3
DEFECTS
to transposition of the flap. covered by the sartorius.
Case
Case
LARGE
exposed
femoral
vessels
flap transposed
was closed
dehiscence
directly.
of a block
dissection
wound.
were tiryr
I4
BRITISH
FIG. 6. Case
2.
JOURNAL
OF PLASTIC
SURGERY
The musculocutaneous flap raised and ready for transposition, FIG. 7. Case 2. Final closure. COMMENT
From our experience of over 50 cases, there is no doubt that the tensor fascia lata with its overlying skin may be reliably raised on its major pedicle in dimensions of up to 15 x 30 cm. Transposed into nearby groin defects it supplies well vascularised tissue into areas which are notoriously slow to heal. When the femoral vessels are exposed it has the added advantage of providing muscular protection. Special appreciation to Dr MauriceJ.Jurkiewicz support and encouragement.
and Dr Luis 0.
Vasconez for their continued
REFERENCE HILL, H. L., NAHAI, F. and VASCONEZ,L. 0. (1978). The tensor fascia lata myocutaneous free flap. Plastic and Reconstructive Surgery, 61, 517.
