Operative morbidity associated with groin dissections.
OBJECTIVE
Groin dissection remains the treatment of choice for malignant neoplasms of the skin in the lower extremities and perineum. We sought to quantify the hospital complications after groin dissection, and to identify the patient- and procedure-related factors affecting these complications.


METHODS
We reviewed 20 consecutive patients who underwent a collective 25 groin dissections for malignant neoplasms of the skin between 1996 and 2002 to determine the incidence and degree of morbidity, and to analyze the clinical factors associated with morbidity. An S-shaped incision was used for the first 8 procedures, whereas a straight incision was used for the next 17.


RESULTS
The overall incidences of complications were 24% for wound infection, 52% for skin flap problems, 32% for seromas, 40% for edema, and 4% for hemorrhage, whereas the incidences of moderate to severe complications were 16% for wound infection, 16% for skin flap problems, 12% for seromas, 4% for edema, and 4% for hemorrhage. The incidence of wound infection tended to be higher after S-shaped incisions than after straight incisions ( P = 0.059), and the incidence of leg edema was significantly higher after S-shaped incisions than after straight incisions ( P = 0.028).


CONCLUSIONS
S-shaped incisions more often resulted in lymphatic collection and stagnation, with a higher incidence of wound infections and leg edema than straight incisions. Therefore, we now perform straight incisions to minimize the risk of wound infections and leg edema.
Tonouchi
Hitoshi
H
Department of Innovative Surgery, Mie University School of Medicine, 2-174 Edobashi, Tsu, Mie 514-8507, Japan.
Ohmori
Yukinari
Y
Kobayashi
Minako
M
Konishi
Naomi
N
Tanaka
Kouji
K
Mohri
Yasuhiko
Y
Mizutani
Hitoshi
H
Kusunoki
Masato
M
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D004487:Edema / Q000453:epidemiology; D005260:Female; D006119:Groin / Q000601:surgery*; D006801:Humans; D015994:Incidence; D007866:Leg; D008197:Lymph Node Excision; D008297:Male; D008545:Melanoma / Q000601:surgery*; D008875:Middle Aged; D009017:Morbidity; D010145:Paget Disease, Extramammary / Q000601:surgery; D011183:Postoperative Complications / Q000453:epidemiology*; D012878:Skin Neoplasms / Q000601:surgery*; D013524:Surgical Flaps / Q000009:adverse effects; D013530:Surgical Wound Infection / Q000453:epidemiology*