COMPARISON OF GROIN FLAP DIVISION AT DAY 14 & DAY 21

Dr. Mohammad Zahirul Islam*, Dr. SM Ramiz Ahmed, Dr. Md. Abdul Quiyum, Dr. Md. Mostafa Kamal, Dr. Nirupom Mondal and Dr. Md. Tazrul Islam

ABSTRACT

Background: Pedicled groin flap is a reconstructive option for hand and forearm defect caused by trauma or other etiological factors. Traditionally pedicled groin flap is divided on 21 days in which patient develops stiffness of joints and also longer hospital stay. Early flap division may overcome these problems. Objective: To compare the outcome of groin flap division at day 14 and day 21. Methods: This prospective observational study was carried out among forty patients who presented with soft tissue defect in the distal forearm, palm and dorsum of hand were included in this study according to inclusion and exclusion criteria. Results: Out of forty patients, most of the soft tissue defect occurred due to burn (52.5%) followed by trauma (42.5%) and). Dorsum of the hand and palm defect were involved in 67.50% & 17.50% cases, respectively. 72.5% flap showed very good outcome and 27.5 % shows good result. 5% patients had partial flap loss, 3(7.5%) patients had marginal necrosis, 4(10%) patients had infection but there is no total or subtotal flap loss. Functional outcome in terms of movement of joints was better at day 14 cases and hospital stay was also shorter than day 21 cases. Conclusion: Early division of the groin flap at 14th day could be a better choice with more safety and promising results to prevent inter-phalangeal, wrist, elbow and shoulder joint stiffness and to reduces hospital stay and discomfort of the patient.

Keywords: Pedicled groin flap, hand and palm defect, joint stiffness, flap loss.