2022 AMI Online Salon

Groin Flap for Hand Defect Series

Project Details

  • Entrant Name:  Betsy Weissbrod
  • Client: Uniformed Services University of the Health Sciences
  • Copyright: The Henry M. Jackson Foundation for the Advancement of Military Medicine, 2021
  • Medium/software used: Adobe Photoshop and Illustrator
  • Final presentation format: Course Materials (Print & Digital)
  • Primary Audience: Orthopedic surgeons and other sub-specialty surgeons

Project Description

This series of three individual illustrations demonstrate key steps in creating a pedicled groin flap. These illustrations are utilized in the Combat Orthopedic Trauma Surgery course materials. This course sets combat training competencies and training standards for military medical providers caring for those in harm’s way.A groin flap is a reliable limb-saving procedure when there is extensive soft tissue damage to the hand or wrist. The illustrations provide visual clarity beyond what accompanying course case photos show. The first identifies pertinent anatomical landmarks and structures that must be preserved to ensure flap success and maintain health of the donor site. The second demonstrates the careful dissection of the plane between the sartorius muscle and its superficial fascia. This frees the flap and preserves the superficial circumflex iliac artery and lateral femoral cutaneous nerve. Finally, the hand is transposed to the donor site where the flap is sutured around the defect and the donor site is closed. The point of view (POV) for this series is slightly oblique to the surgeons. It is important to orient viewers as this POV also corresponds with course case photos. Underlying anatomical structures are ghosted under the skin in the anterior view inset and the primary oblique view. This POV provides an ideal view of the sartorius muscle fascia dissection plane and its preserved neurovasculature that is critical for a successful groin flap.