Evaluating Pedicled Groin Flap Reconstruction in Hand Degloving Injuries: A Retrospective Analysis

Abstract

Purpose

This study aimed to evaluate the clinical outcomes of pedicled groin flap coverage in such injuries and identify factors associated with postoperative complications and flap viability.

Methods

A retrospective review of 23 patients who underwent pedicled groin flap reconstruction for finger or hand degloving injuries between 2015 and 2024 was conducted. Patient demographics, surgical details, complication rates, aesthetic outcomes, and functional recovery were analyzed.

Results

The cohort had a mean age of 27.9 years, with a male predominance (73.9%) and a high smoking rate (73.9%). Most defects involved the fingers (87%), with a mean defect size of 30.6 cm² and a mean flap size of 72.0 cm². The mean wound healing time was 32.5 days, and the average hospital stay was 3.6 days. Flap success was achieved in 91.3% of the cases. Postoperative complications occurred in 34.8% of the patients, including partial flap necrosis (26.1%), wound dehiscence (13.0%), and infection (4.3%). Intraoperative venous congestion was observed in 39.1% of the cases and was more frequent among patients who developed complications (P = .001). Other variables showing statistically significant differences between patients with and without complications included smoking status (P = .037), additional procedures performed (P = .037), and smaller defect dimensions (P = .011 for width; P = .032 for size). Aesthetic outcomes were rated as good or neutral in over 90% of the cases. Functionally, 91.3% of the patients experienced minimal-to-mild disability, with a mean QuickDASH score of 18.1 (SD = 14.1). Patients with complications had higher disability scores (mean: 27.9 vs 12.9; P = .012).

Conclusions

Groin flap reconstruction remains a reliable and accessible option for managing hand degloving injuries, particularly in resource-limited settings, offering acceptable functional and aesthetic outcomes despite a relatively high rate of secondary procedures.

Type of study/level of evidence

Therapeutic III.