Versatility of Vastus Lateralis muscle flap for groin and pelvic wound: An Updated Anatomical Description and Clinical Applications

Abstract Purpose: To evaluate the use of the vastus lateralis (VL) muscle flap for groin and pelvic wound coverage, particularly in cases involving complex vascular exposure or high risk of contamination. Cadaveric dissection and two clinical cases were analyzed to assess the utility of the VL muscle flap. Methods: Bilateral dissections were performed on five fresh cadavers to measure anatomical parameters of the VL and rectus femoris muscles, focusing on technical aspects for the flap dissection, muscle length, vascular supply, and flap dimensions. Two case examples are then presented in patients who underwent reconstructive procedures using the VL flap: one for coverage following femoral bypass and another for a pelvic defect after ligation of the external iliac artery. Results: Cadaveric dissections confirmed the VL muscle's consistent vascular anatomy and adequate length, extending beyond the rectus femoris musculotendinous junction by an average of 4.3 cm. The flap’s dimensions and robust blood supply suggest suitability for reconstructive applications in the groin and pelvis. Clinically, the VL flap successfully provided coverage in both patients with minimal donor-site morbidity and preserved lower extremity function. Conclusion: The VL muscle flap is a reliable option for groin and pelvic reconstruction, offering sufficient reach, volume, and reduced donor-site morbidity compared to other muscle flaps. Further studies are needed to confirm its advantages in broader clinical settings.