| Objective:1. By Anatomical study of fresh specimens,observations groin flap blood supply and study the vascular origin, direction, vessel diameter,in order to provide anatomical data and anatomical images of fresh specimens,and provide anatomic evidence for the application of the free groin flap.2. To explore the surgery technique and outcome for the clinic application of the free groin flap for large hand defect,and we hope to improve the value of this flap for its clinic application.Methods:1.12 fresh specimens were used in this study, and each specimen was perfusion of red emulsion through common carotid arteries or femoral arteries. Through microdissection of groin area, the blood supply of the flap is observed, in which the origin, travelling, distribution and diameter of the pedicle vessels were included. All the diameters were measured by vernier caliper, the reading error is 0.02mm.,Spss13.o was employed for the results analysis.2. On the basis of the anatomy ,we employed 16 cases which were appreciated for the groin flap surgery in this study, and followed up in 5-12 months,observed subjective opinion and objective opinion, analysis the clinical effect of this flap.Results:Anatomy:①Of all the 12 cadavers superficial circumflex iliac artery(SCIA) is the nutrient artery of the groin flap in 11 cadavers, however, superficial circumflex iliac artery (SCIA)is absent in the left cadaver.②By observing all the fresh specimens,75% (9/12)of the SCIA originated in the femoral artery, 8.33% of the SCIA originated in the Deep circumflex iliac artery (DCIA), 8.33% of the SCIA originated in the lateral femoral circumflex artery,and one case we could not find the SCIA.③The average diameter of superficial circumflex iliac artery is 1.48±0.41mm, the average diameter of the original trunk which shared superficial circumflex iliac artery with superficial iliac epigastric artery is 2.02 mm.④The average distances from the origins of superficial circumflex iliac artery and superficial iliac epigastric artery (SIEA)to the origin of femoral arteries are 13.93±8.71mm,26.93±13.18mm individually, and if they share the same trunk ,the average distance from the origin of the trunk to the origin of femoral artery is 17.55±7.35mm. Three vessels in the femoral artery on the starting point of order on the grounds outside and within the former, top-down order.Clinic application: We applied the groin flap to 16 cases in which the minimum area is7cm×5cm and the maximum area is 15cm×9cm..All the flaps survived, except veins compromise happened in 2 cases (survived after timely treatment) all the other flaps survived without a hitch. We did follow-up in 5-12 months, the flaps had survived completely and had good qualities, appearance and elasticity. The good rates of all the flaps are 93.75%. the sensation recovered partly. The donor parts were left with linear scar. Except sensation dysfunction happened in one case, no patients had any complication.Conclusion:The groin flap is supplied by the superficial circumflex iliac artery which is relatively stable and easy for dissection, and flap elevation does no harm to the deep tissue, and is appropriate for free transplantation.For the groin flap has the advantages of large area, proper pedicle vessels, easy for anastomosis, high surviving rates, good appearance, with no harm to the major vessels or nerves and less complications. It is a good method to use this flap to repair skin and soft tissue defects of hand. |
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