الفهرس 
IntroductionOnly 14 pages are availabe for public view
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Abstract
Complex groin wounds pose a serious challenge to patients and their caregivers alike. The bad groin vascular supply present the tendo- Achilles point in groin wound healing also cut of most of these vascular channels during groin dissection worsen the situation more and more.
The main causes for groin skin defects were found to be groin dissection for inguinal lymphadenectomy , resection of tumors from groin area, groin suppurations especially in drug dependant , and people who have bad hygiene , hydra adenitis suppurativa in groin
area, and groin skin trauma, which may be direct trauma , de-gloving skin injury, and chemical or physical burns and also they occur commonly in many surgical subspecialty patient populations including those patients undergoing infra inguinal bypass , femoral canulation for cardiac cathterization who usually have a complex groin wounds .
Many methods were advocated for coverage and reconstruction of complex groin wounds including regular dressing waiting for healing by secondary intention , skin grafts , omental flap advancement skin flaps. These methods had the least popularity except for advancement skin flaps and nearly disappeared after evolution of the era of local pedicled flaps such as Sartorius flap, Gracilis flap Antrolateral thigh flap, Tensor fascia lata flap, Inferiorly based Rectus abdominis flap , and Rectus femoris flap. These flaps in fact had solved the problem to far extent .
The aim of this study was to study the different modalities for groin reconstruction.
Thirty patients with complex groin wounds had undergone a groin reconstruction using either Antrolateral thigh flap, Tensor fascia lata flap, and Rectus femoris flap six patients for each flap and twelve patient for Inferiorly based Rectus abdominis flap ( vertical or transverse ). All patients underwent routine laboratory investigations chest radiograph and ECG preoperatively.
Socio- demographic data , defect size, co morbidities , history of previous abdominal operations were documented pre operatively.
Amount of blood loss , amount of transfused blood , net length of operations, and any intra operative complications were recorded intra operatively. where hospital stay time , occurrence of any post operative complications and any donor site morbidity were recorded post operatively. These records were done for all patients and
with all flaps.
Our results had established the fact that the all the flaps had the same chances statistically in socio – demographic data of the patients , defect size, previous abdominal operation, and comorbidity and the only thing that may affect results may be the original cause of groin wounds which cannot be controlled by us .
Our results had documented that none of the used flaps was favored over the others statistically regarding blood loss , net time of operations , length of hospital stay, rate of complications , and donor site morbidity.
In fact each flap has its own favors and drawbacks . For example we found that the Inferiorly based Rectus abdominis flap ( vertical transverse ), and Rectus femoris flap can provide more bulk to defect.
While the Antrolateral thigh flap , Inferiorly based Rectus abdominis flap ( vertical , transverse ), and Rectus femoris flap can be used for contra lateral side if vascularity of the ipsilateral side is questionable but Inferiorly based Rectus abdominis flap ( vertical , transverse ),is technically easy to harvest while Antrolateral thigh flap and Rectus femoris flap for contra lateral side are more demanding. We also found that the Antrolateral thigh flap, Tensor fascia lata flap and
Inferiorly based Rectus abdominis flap ( vertical , transverse ) can provide a large surface area but carries higher rate of complications while the least complication was documented with Rectus femoris flap. We found that in spite of all these views the overall survival of the flaps ,success, and complication rates have not a statistically significant affection by them.
Lastly we can say that there is no super flap or bad flap there is a situation that imply its requirement for a flap this makes the choice of the flap based on situation of blood supply to limp , requirement for bulky flap or a flap with large surface area or not , situation of primary operation , fitness of the patient and lastly surgeon’s personal experience for flap .