The Taylor First Free Flap and the Groin Flap: A Historical Clarification

In an era marked by the increasing popularity of the superficial circumflex iliac artery perforator flap, the “groin flap” is often mentioned as the first successful case of a cutaneous free flap, as reported by Taylor and Daniel in 1973.1–3 Originally described by Smith et al,4 the groin flap is based on the superficial circumflex iliac artery (SCIA). This has led to the misconception that the flap transferred by Taylor and Daniel was a groin flap based on the SCIA.1–3 We believe that this inaccuracy must be clarified to prevent its continued perpetuation: the free flap transferred by Taylor and Daniel5 was based on the superficial inferior epigastric artery (SIEA), not the SCIA. In their article, Taylor and Daniel described how, during the preparation of this flap from the inguinal region, they found the SCIA to be too small for anastomosis. Fortunately, they had included the SIEA in the flap, which had a more suitable caliber for the transfer as a free flap. The misunderstanding arises from the fact that both the groin flap, based on the SCIA, by Smith et al and the “ilio-femoral” flap by Taylor and Daniel are harvested from the region commonly referred to as the groin or inguinal region, and the SCIA and SIEA have overlapping vascular territories. In a subsequent article, in fact, Harii et al6 discussed “free groin skin flaps,” referring to flaps harvested from the inguinal region that can be based on either the SIEA or the SCIA, using one or the other artery depending on the more suitable caliber for anastomosis. Consequently, according to Harii et al, the term “groin flap” could be assigned to flaps based on either the SCIA or the SIEA (because the anatomic area remains the groin). This may have contributed to the confusion in the literature. What is certain is that stating or implying that the flap by Taylor and Daniel is a groin flap based on the SCIA is incorrect. To avoid misunderstandings, it would be more appropriate to refer to the first flap of Taylor and Daniel by the name they used themselves, the ilio-femoral flap, rather than the groin flap, a term generally used to refer to the flap by Smith et al that was based on the SCIA. DISCLOSURE The authors have no financial interest to declare in relation to the content of this article.