Modified skin bridge technique for ilio-inguinal lymph node dissection: A forgotten technique revisited

Abstract

Ilio-inguinal lymph node dissection (IILD) is a commonly performed surgical procedure for a number of malignant conditions involving mainly the male and female genitalia, and the skin; however the postoperative morbidity of IILD, due to high frequency of flap necrosis, wound infection and seroma formation, has always been a major concern for the surgeons. The aim of the study is to highlight a modified skin bridge technique of IILD using two parallel curvilinear incisions to minimize postoperative skin flap necrosis. This technique was successfully employed in 38 IILD during May 2012 to November 2013. None of the patient had flap necrosis. Two patients developed seroma while another two patients had superficial surgical site infection; they were managed conservatively. Modified skin bridge technique for IILD is an effective method to minimize flap necrosis without compromising the oncological safety.

Keywords: Skin bridge technique; Wound infection; Ilio-inguinal lymphadenectomy; Flap necrosis

Core tip: Ilio-inguinal lymph node dissection (IILD) has classically been associated with high postoperative complications which include flap necrosis, wound infection, seroma formation, and lymphedema. A modified skin bridge technique of performing IILD aims to minimize the postoperative wound complications. It is an effective method to minimize flap necrosis without compromising adequate oncologically safe dissection.