title: Tensor fascia lata flap reconstruction following groin dissection: is it worthwhile?
abstract: OBJECTIVE
  To compare the morbidity of primary skin closure with elective Tensor Fascia Lata (TFL) flap cover in groin dissections.
  
  
  METHODS
  This was a retrospective study between January 2007 and December 2009. All patients undergoing groin dissections without skin involvement were included.
  
  
  RESULTS
  Of the twenty-five patients, who underwent groin dissections, 14 had primary skin closure (28 groin dissections)-group I. Eleven had TFL flap cover as a means of primary reconstruction (20 groin dissections)-group II. In group I, there were 16 (57%) inguinal dissections and 12 (43%) ilioinguinal block dissections, whereas 82% in group II underwent ilioinguinal dissections (p = 0.09). Wound infection requiring treatment with a culture specific antibiotic was required in 4 (14%) in group I (n = 28) and only 1 (5%) in group II (n = 20) (p = 0.38). In group I, 7 (25%) had major flap necrosis and minor necrosis was seen in another 7 (25%). Only three (15%) in group II developed minor flap necrosis (p = 0.01). Following an ilioinguinal dissection, flap necrosis occurred in 75% of groins that underwent primary closure and in 17% of those which were reconstructed with TFL (p = 0.001). Seroma formation was seen in 5 (18%) in group I and 3 (15%) in group II (p = 1.0). Lymphoedema occurred in equal numbers in both groups. The duration of hospital stay was 20 ± 14 days in the primary closure group and 16 ± 3 days in the TFL group.
  
  
  CONCLUSIONS
  The TFL flap can reduce postoperative morbidity and decrease hospital stay. Prophylactic TFL flap reconstruction following ilioinguinal dissections is advisable.
authors.affiliation: Department of Urology, Christian Medical College, Vellore, Tamil Nadu, 632004, India. nirmaltj@gmail.com
authors.forename: T J
authors.initials: TJ
authors.lastname: Nirmal
authors.forename: Ashish K
authors.initials: AK
authors.lastname: Gupta
authors.forename: Santosh
authors.initials: S
authors.lastname: Kumar
authors.forename: Antony
authors.initials: A
authors.lastname: Devasia
authors.forename: Ninan
authors.initials: N
authors.lastname: Chacko
authors.forename: Nitin S
authors.initials: NS
authors.lastname: Kekre
mesh_terms: D000328:Adult; D000368:Aged; D002294:Carcinoma, Squamous Cell / Q000473:pathology / Q000601:surgery; D006119:Groin / Q000601:surgery*; D006801:Humans; D007902:Length of Stay; D008197:Lymph Node Excision; D008297:Male; D008875:Middle Aged; D018482:Muscle, Skeletal / Q000601:surgery*; D009367:Neoplasm Staging; D010412:Penile Neoplasms / Q000473:pathology / Q000601:surgery; D019651:Plastic Surgery Procedures / Q000379:methods*; D012189:Retrospective Studies; D013524:Surgical Flaps; D016896:Treatment Outcome; D014945:Wound Healing