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.
Objective: This study aimed to compare between pedicled
groin flap and free anterolateral thigh flap in complex hand
defects reconstructions regarding patient demographics, flap < br />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.