Background: Soft tissue defects of the hand present a significant challenge in reconstructive surgery due to the hand's intricate anatomy and essential functional role. One of the main considerations in hand reconstruction is the choice of an appropriate flap. Among the various flaps used in hand reconstruction, the pedicled groin flap and the free anterolateral thigh flap have gained significant attention.
Aim of work: This study aimed to compare between pedicled groin flap and free anterolateral thigh flap in complex hand defects reconstructions regarding patient demographics, flap outcomes, complication rates, donor site morbidities and hospitalization period.
Material and methods: This multicenter prospective clinical trial was conducted from March 2021 to March 2022 on 20 patients with a clinical diagnosis of soft tissue defects of hand recruited from the Plastic Surgery Unit at General Surgery department, Faculty of Medicine, Benha University Hospital and Plastic Surgery department, Faculty of Medicine and Al Azhar University. Patients were divided into two groups, group (A) 10 patients who underwent pedicled groin flap and group (b): 10 patients who underwent free anterolateral thigh flap.
Results: There were 14 males and 6 female Their age ranged from 18-62 year .7 cases resulting from crush injury, 5 cases were due to burn and 8 cases were due to friction burn. Out of 10 patients who were reconstructed by pedicled groin flap, 1 patient (10%) was complicated by partial wound dehiscence and only 1 patient (10%) was complicated by infection. out of 10 patients were reconstructed by The free anterolateral thigh flap 1 (10%) patient complicated by flap failure , 1 (10%) patient complicated by partial wound dehiscence and only 1 (10%) patient complicated by infection.
Conclusion: The pedicled groin flap demonstrated favorable outcomes in older patients, leading to shorter operation times and hospital stays, making it a practical option for cases with relatively smaller defects. Conversely, the free anterolateral thigh flap proved suitable for complex large hand defects involving exposed tendons and joints, and it tended to be utilized more often in younger patients. Patient satisfaction and complication rates were compared between the two groups.
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