The hemangioma exhibits rapid proliferation and slow regression during childhood. The hip can be extended over the course of a few days.Hemangiomas are considered to be the most common tumors in infants they are three times more common in females than in males. In cases of excessive tension, a layered closure over the suction drains and slight hip flexion was required. The donor area is closed after slight undermining superficial to the deep fascia. The vein arises from either the saphenous vein or a branch of the superficial femoral vein. The artery may arise either from the femoral vessel/ trunk/ or parent vessel supplying the SCIA and DCIA or may arise from the common trunk that becomes the SIEA. The flap was mobilized on the vascular pedicle. The fascial plane was incised around the pedicle at the medial aspect of the sartorius muscle, and the vessels (artery and vein) were dissected from their origin. All muscular branches were ligated to reduce blood loss. Skin incisions extended inferiorly and medially to relieve tension in order to avoid transecting the pedicle.
As the dissection continued medially, the superficial circumflex iliac vessels became visible in the plane above the Sartorius heading into the muscular fascia. After identifying the lateral aspect of sartorius, the muscular fascia is incised along the lateral aspect, and the flap elevation plane is now conducted deep to the muscular fascia. The nerve may require transection depending in its course.
Structures visualized during the dissection included the perforating vessels which were ligated as well as the lateral femoral cutaneous nerve of the thigh as it leaves the deep fascia to enter the subcutaneous tissue. The incision was extended downwards to the deep fascia where the dissection started medially till the level of the anterior superior iliac spine (ASIS), the interval between the tensor fascia lata and the Sartorius muscle. We preferred to start the incision superiorly and elevate from the distal superior aspect towards the flaps’ medial aspect.
The flap dissection can be started laterally or medially. Pinching of the skin to assess the tension of closure of the flap after harvesting is done to identify the maximum width of the design.
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