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Article Navigation >  CHINESE JOURNAL OF BURNS AND WOUNDS  >  > Accepted Manuscript
Du Weili,Liu Zixi,Xiong Feng,et al.Clinical evaluation and repair strategies for complex inguinal wounds[J].Chin J Burns Wounds,2026,42(8):1-8.DOI: 10.3760/cma.j.cn501225-20260505-00182.
Citation: Du Weili,Liu Zixi,Xiong Feng,et al.Clinical evaluation and repair strategies for complex inguinal wounds[J].Chin J Burns Wounds,2026,42(8):1-8.DOI: 10.3760/cma.j.cn501225-20260505-00182.
shu

Clinical evaluation and repair strategies for complex inguinal wounds

doi: 10.3760/cma.j.cn501225-20260505-00182

  • Department of Burns and Plastic Surgery, Beijing Jishuitan Hospital, Capital Medical University, Beijing 100035, China

Funds:

Research and Cultivation Program of Beijing Capital Hospital PX2024016

Subject Backbone of Beijing Jishuitan Hospital XKGG202209

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    Abstract
  •   Objective  To explore the clinical evaluation and repair strategies for complex inguinal wounds.  Methods  This study was a retrospective case series study. Between September 2020 and December 2025, 15 patients with complex inguinal wounds meeting the inclusion criteria were admitted to Beijing Jishuitan Hospital of Capital Medical University. There were 10 males and 5 females, aged 12 to 79 years. Preoperatively, detailed medical history inquiry, physical examination, and multiple auxiliary examinations were performed to precisely evaluate the involvement of vital anatomical structures and infectious status in the inguinal region. After timely management of femoral artery lesions, precise debridement was carried out. The sizes of inguinal wounds after debridement ranged from 11.0 cm×4.0 cm to 20.0 cm×9.0 cm. According to the wound bed conditions after debridement, well-vascularized tissue flaps were selected to obliterate the wound cavity and achieve wound closure. The following data were recorded, including the involvement of femoral vessels by the wound, the exposure and retention or removal of prosthetic vascular grafts, management of the femoral artery in patients with radiation-induced wounds, type and size of the adopted tissue flaps, closure methods of the donor site wounds, results of bacterial culture of preoperative wound exudate samples, and intraoperative histopathological examination of wounds. The tissue flaps survival and wound healing were observed at postoperative two weeks. During follow-up, the appearance of tissue flaps, recurrence of wounds, patency of femoral artery, swelling of the affected limb, scar formation of the donor sites, and occurrence of abdominal wall hernia at the donor site of rectus abdominis musculocutaneous flap were observed.  Results  All inguinal wounds involved the femoral vessels. Exposure of the prosthetic vascular graft was observed in 4 patients, among which the prosthetic vascular graft was preserved in three patients and removed in one patient. Two patients received preoperative covered stent implantation, one patient underwent intraoperative femoral artery resection and implantation with the prosthetic vascular graft, and femoral artery was successfully preserved without rupture in the remaining patients. The inguinal wounds were repaired with thoracoumbilicus flap combined with rectus abdominis musculocutaneous flap in 11 patients, tensor fasciae latae musculocutaneous flap combined with sartorius muscle flap in one patient, tensor fasciae latae musculocutaneous flap combined with rectus femoris muscle flap in one patient, and pedicled anterolateral thigh flap chimerized with vastus lateralis muscle flap in two patients. The sizes of tissue flaps ranged from 13.0 cm×6.0 cm to 26.0 cm×14.0 cm. Only the donor site wound in one patient was covered with split-thickness skin graft, and the donor site wounds in remaining 14 patients were closed by primary suture. Bacterial culture of preopertive wound exudate samples showed monomicrobial infection in 7 patients and mixed infection of two types of bacteria in 8 patients. Intraoperative histopathological examinations of wounds revealed inflammatory changes without neoplastic component. The tissue flaps in all patients survived completely and the wounds healed well at postoperative two weeks. During follow-up of 6 months to 3 years, most of the tissue flaps maintained satisfactory appearance, while a small number of tissue flaps presented mild bulkiness. No wound recurrence was observed. Computed tomography angiography confirmed patent femoral arteries in 14 patients, and obvious relief of preoperative lower limb swelling was achieved in 9 patients. The donor site with skin grafting showed unremarkable scarring in one patient, while mild linear scars were noted at the donor sites in the other 14 patients. No abdominal wall hernia occurred at the donor sites of rectus abdominis musculocutaneous flaps.  Conclusions  For complex inguinal wounds, optimal clinical repair outcomes can be achieved via preoperative precise evaluation of major vessels, prosthetic vascular grafts, and soft tissue infection, and adequate vascular intervention, intraoperative precise debridement, followed by wound closure using well-vascularized tissue flaps.

     

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