Skin incisions in inguinal lymph-node excision
Tritsch, H.
Der Hautarzt; Zeitschrift für Dermatologie Venerologie und verwandte Gebiete 29(10): 531-535
1978
ISSN/ISBN: 0017-8470 PMID: 361637 Document Number: 132728
Wound complications in the postoperative period of the inguinal lymph node dissection are frequent events. The main factor in wound complications is due to dissection of the vascular architecture. In most of the cases the impaired wound healing occurs distal to Poupart's ligament. Suggestion for its prevention is the use of an oblique, subinquinal, wide spindle-S-shaped skin excision crossing over Scarpa's triangle with an extension to the anterior superior iliac spine from its lateral and a vertical prolongation onto the thigh from its medial end. The wide spindle-S-shaped excision minimizes the later devascularisation of skin flaps. The anatomic outline of the inguinal lymphatic basin to be removed can easily be reached by the extend of these two incision lines. Besides an undisturbed healing the technique offers two further possibilities. If malignant skin tumors are in anatomical positions which lend themselves to incontinuity dissection, removing primary tumor, intervening lymphatics and regional lymph nodes en bloc can be combined with the incision lines. Furthermore the excised groin skin can be used for a free flap to cover the excision wound of the primary tumor. The method is described in ten cases.