Feasibility and safety of the Lymphatic Superficial Iliac Artery Perforator (L-SCIP) flap following inguinal lymph node dissection in reducing postoperative complications in patients with cancer

Article summary: Introduction: Inguinal lymph node dissection (ILND) is crucial for staging and treating several malignancies, but it is often associated with significant morbidity due to postoperative complications. This case series aimed to evaluate the safety and feasibility of using the superfi...

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Main Authors: Alieske Kleeven, Eleftheria Karavolia, Kristien B.M.I. Keymeulen, Barbora Horehledova, Guillaume A. Padmos, Yasmine M.J. Jonis, Shan Shan Qiu
Format: Article
Language:English
Published: Elsevier 2025-06-01
Series:JPRAS Open
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Online Access:http://www.sciencedirect.com/science/article/pii/S2352587825000774
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author Alieske Kleeven
Eleftheria Karavolia
Kristien B.M.I. Keymeulen
Barbora Horehledova
Guillaume A. Padmos
Yasmine M.J. Jonis
Shan Shan Qiu
author_facet Alieske Kleeven
Eleftheria Karavolia
Kristien B.M.I. Keymeulen
Barbora Horehledova
Guillaume A. Padmos
Yasmine M.J. Jonis
Shan Shan Qiu
author_sort Alieske Kleeven
collection DOAJ
description Article summary: Introduction: Inguinal lymph node dissection (ILND) is crucial for staging and treating several malignancies, but it is often associated with significant morbidity due to postoperative complications. This case series aimed to evaluate the safety and feasibility of using the superficial circumflex iliac artery perforator (L-SCIP) flap, enriched with lymphatic tissue, following ILND and examine its possible effect in preventing these complications. Methods and Results: A retrospective case series was conducted involving 5 consecutive patients with cancer who underwent ILND followed by an L-SCIP flap in a single procedure at Maastricht University Medical Center between March 2023 and February 2024. A progressive reduction in operative times was noted, decreasing from 125 to 105 min across the 5 cases. The median hospital stay was 3 days and drains were removed after a median of 17 days. Three patients experienced complications within the first 3 months after surgery, which included seroma formation, partial necrosis of the native skin of the thigh or flap, wound infection, need for reoperation, and transient swelling of the leg. The median follow-up period was 7.84 months. Circumference, surface, and skin thickness measurements of the affected leg predominantly showed an increase postoperatively. Conclusion: The L-SCIP flap performed immediately after ILND is a feasible and safe method, potentially leading to shorter hospital stays and earlier drain removal. However, seroma and wound infection remained the most common complications, suggesting that although the L-SCIP flap may enhance healing, it does not fully mitigate these complications. Therefore, further research is needed to assess the long-term benefits.
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spelling doaj-art-2b0855a8b2bc42628af691c8d5e2b7ce2025-08-20T02:26:09ZengElsevierJPRAS Open2352-58782025-06-014451152310.1016/j.jpra.2025.04.008Feasibility and safety of the Lymphatic Superficial Iliac Artery Perforator (L-SCIP) flap following inguinal lymph node dissection in reducing postoperative complications in patients with cancerAlieske Kleeven0Eleftheria Karavolia1Kristien B.M.I. Keymeulen2Barbora Horehledova3Guillaume A. Padmos4Yasmine M.J. Jonis5Shan Shan Qiu6Department of Plastic, Reconstructive, and Hand Surgery, Maastricht University Medical Center, Maastricht, the NetherlandsDepartment of Plastic, Reconstructive, and Hand Surgery, Maastricht University Medical Center, Maastricht, the NetherlandsDepartment of Surgery, Maastricht University Medical Center, Maastricht, the NetherlandsDepartment of Clinical Imaging, Zuyderland Medical Center, Sittard-Geleen, the NetherlandsDepartment of Radiology, Maastricht University Medical Center, Maastricht, The NetherlandsDepartment of Plastic, Reconstructive, and Hand Surgery, Maastricht University Medical Center, Maastricht, the NetherlandsDepartment of Plastic, Reconstructive, and Hand Surgery, Maastricht University Medical Center, Maastricht, the Netherlands; Corresponding author: Shan Shan Qiu, Maastricht University Medical Center, P. Debyelaan 25, 6229 HX, Maastricht.Article summary: Introduction: Inguinal lymph node dissection (ILND) is crucial for staging and treating several malignancies, but it is often associated with significant morbidity due to postoperative complications. This case series aimed to evaluate the safety and feasibility of using the superficial circumflex iliac artery perforator (L-SCIP) flap, enriched with lymphatic tissue, following ILND and examine its possible effect in preventing these complications. Methods and Results: A retrospective case series was conducted involving 5 consecutive patients with cancer who underwent ILND followed by an L-SCIP flap in a single procedure at Maastricht University Medical Center between March 2023 and February 2024. A progressive reduction in operative times was noted, decreasing from 125 to 105 min across the 5 cases. The median hospital stay was 3 days and drains were removed after a median of 17 days. Three patients experienced complications within the first 3 months after surgery, which included seroma formation, partial necrosis of the native skin of the thigh or flap, wound infection, need for reoperation, and transient swelling of the leg. The median follow-up period was 7.84 months. Circumference, surface, and skin thickness measurements of the affected leg predominantly showed an increase postoperatively. Conclusion: The L-SCIP flap performed immediately after ILND is a feasible and safe method, potentially leading to shorter hospital stays and earlier drain removal. However, seroma and wound infection remained the most common complications, suggesting that although the L-SCIP flap may enhance healing, it does not fully mitigate these complications. Therefore, further research is needed to assess the long-term benefits.http://www.sciencedirect.com/science/article/pii/S2352587825000774Inguinal dissectionInguinal dissection complicationsL-SCIP flapLymphangiogenesisCancer-related lymphedema
spellingShingle Alieske Kleeven
Eleftheria Karavolia
Kristien B.M.I. Keymeulen
Barbora Horehledova
Guillaume A. Padmos
Yasmine M.J. Jonis
Shan Shan Qiu
Feasibility and safety of the Lymphatic Superficial Iliac Artery Perforator (L-SCIP) flap following inguinal lymph node dissection in reducing postoperative complications in patients with cancer
JPRAS Open
Inguinal dissection
Inguinal dissection complications
L-SCIP flap
Lymphangiogenesis
Cancer-related lymphedema
title Feasibility and safety of the Lymphatic Superficial Iliac Artery Perforator (L-SCIP) flap following inguinal lymph node dissection in reducing postoperative complications in patients with cancer
title_full Feasibility and safety of the Lymphatic Superficial Iliac Artery Perforator (L-SCIP) flap following inguinal lymph node dissection in reducing postoperative complications in patients with cancer
title_fullStr Feasibility and safety of the Lymphatic Superficial Iliac Artery Perforator (L-SCIP) flap following inguinal lymph node dissection in reducing postoperative complications in patients with cancer
title_full_unstemmed Feasibility and safety of the Lymphatic Superficial Iliac Artery Perforator (L-SCIP) flap following inguinal lymph node dissection in reducing postoperative complications in patients with cancer
title_short Feasibility and safety of the Lymphatic Superficial Iliac Artery Perforator (L-SCIP) flap following inguinal lymph node dissection in reducing postoperative complications in patients with cancer
title_sort feasibility and safety of the lymphatic superficial iliac artery perforator l scip flap following inguinal lymph node dissection in reducing postoperative complications in patients with cancer
topic Inguinal dissection
Inguinal dissection complications
L-SCIP flap
Lymphangiogenesis
Cancer-related lymphedema
url http://www.sciencedirect.com/science/article/pii/S2352587825000774
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