Radical inguinal lymphadenectomy (RIL) for bulky metastatic melanoma and non-melanoma skin cancers of the inguinal region, while shown to improve morbidity and survival oncologically, can result in substantial morbidity from wound complications. Skin defects cannot be closed primarily and the substantial dead space predisposes to seroma, wound dehiscence and infection.

The Quadriceps Keystone Island Flap (QKIF) is an effective means of reconstructing inguinal defects after RIL, particularly in high-risk patients, and is technically simpler than other reconstructive techniques advocated for this purpose. Furthermore, the QKIF offers patients with advanced disease (where management is primarily palliative) a potentially improved quality of life with reduced operative morbidity.

‘Quadriceps Keystone Island Flap for Radical Inguinal Lymphadenectomy: A reliable locoregional island flap for groin defects.’ Co-authors: Behan FC, Paddle A, Rozen WM, Ye X, Speakman D, Henderson MA. ANZ J Surg. 2011 Mar 17 (Epub ahead of print).