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.

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.