title: The effectiveness of pedicled groin flaps in the treatment of hand defects: results of 49 patients.
abstract: OBJECTIVE
  Despite the growing number of free and local flaps used for repairing defects of the hand, groin flaps are also still widely used. The aims of this study were to evaluate the outcome of a large series of patients whose defects were covered by pedicled groin flaps, and to find out whether it is still indicated in replacing damaged soft tissue of the hand in the era of microsurgery.
  
  
  METHODS
  From 1982 to 2009, we treated 85 patients with soft tissue defects on the hand and distal forearm with pedicled groin flaps in our department and recorded them in a prospective database. We interviewed and examined 49 patients in this cohort.
  
  
  RESULTS
  The mean age of the 85 patients was 33 years, the male/female ratio was 4:1, the mean hospital stay was 29 ± 13 days, and the mean follow-up was 9 years. The duration to flap division was 24 ± 5 days. Altogether, we performed a mean of 4.6 operations per patient, including thinning of the flap, deepening of the interdigital fold, and stump and flap revisions. One flap loss occurred. Of the 49 patients, results were mostly classified as good, and 82% of patients would undergo the procedure again. The mean Disabilities of the Arm, Shoulder, and Hand score value was 23 ± 17. The Vancouver Scar Scale showed nearly normal height and vascularity of the groin flap (0.2 ± 0.4 and 0.3 ± 0.6, respectively), pigmentation was slightly abnormal (0.8 ± 0.6), and pliability was evaluated between "supple" and "yielding" (1.5 ± 1.2).
  
  
  CONCLUSIONS
  Results achieved with the groin flaps were positive. Most patients were satisfied with the results, and the operation was easily performed when McGregor's recommendations were followed. Nevertheless, considering the high number of secondary operations, the long hospital stay, and immobilization of the arm, groin flaps should be used only when free flaps or regional pedicle flaps are either not feasible or not indicated.
  
  
  METHODS
  Therapeutic III.
authors.affiliation: Department of Plastic and Hand Surgery, Burn Center, BG-University Hospital Bergmannsheil, Ruhr-University Bochum, Buerkle-de-la-Camp-Platz1, 44789 Bochum, Germany. ole.goertz@rub.de
authors.forename: Ole
authors.initials: O
authors.lastname: Goertz
authors.forename: Nicolai
authors.initials: N
authors.lastname: Kapalschinski
authors.forename: Adrien
authors.initials: A
authors.lastname: Daigeler
authors.forename: Tobias
authors.initials: T
authors.lastname: Hirsch
authors.forename: Heinz H
authors.initials: HH
authors.lastname: Homann
authors.forename: Lars
authors.initials: L
authors.lastname: Steinstraesser
authors.forename: Marcus
authors.initials: M
authors.lastname: Lehnhardt
authors.forename: Hans U
authors.initials: HU
authors.lastname: Steinau
mesh_terms: D000293:Adolescent; D000328:Adult; D002648:Child; D002675:Child, Preschool; D002921:Cicatrix / Q000145:classification; D015331:Cohort Studies; D004185:Disability Evaluation; D005260:Female; D005500:Follow-Up Studies; D058752:Free Tissue Flaps / Q000098:blood supply; D006230:Hand Injuries / Q000601:surgery*; D006801:Humans; D007223:Infant; D007902:Length of Stay / Q000706:statistics & numerical data; D008297:Male; D008875:Middle Aged; D017060:Patient Satisfaction; D011183:Postoperative Complications; D060053:Transplant Donor Site; D055815:Young Adult