The Coverage of Large Skin Tissue Losses of the Hand by the Mc Gregor Flap

Abstract

Introduction: Large defects of the hand pose a coverage problem. Several procedures are available, the flap of Mc Gregor or groin flap still retains an important place in the management of these skin defects. Materials and Methods: It is a retrospective study of 50 patients presenting a skin defect of the hand needing a flap coverage by a pedicled Mc Gregor flap collected at the plastic and burns surgery department, of the University hospital of Nabeul, Tunisia. Results: Our study is made of 50 patients with a male predominance (sex ratio = 1.5); and an average age of 40 years. The substance loss was post traumatic in 22 cases and post infectious in 28 cases. The location was mainly the dorsal side of the hand (30 cases), with an average surface area of 50 cm2. The average coverage delay was 5 days with nursing period of 21 days. We made 47 fascio-cutaneous flaps and 3 composite ones. In the short term, we noted a distal necrosis of the flap in 3 cases, a breakdown of sutures in 5 cases. In the long term, an overall satisfactory result was found in 90% of cases. Conclusion: Due to its reliability and technical simplicity, the flap of Mc Gregor is still relevant today.