The transverse incision is made parallel to the inguinal ligament either superiorly or inferiorly to the skin crease directly over the femoral artery. The subcutaneous tissue is dissected in the transverse direction till Scarpaes fascia after which the dissection is performed in the longitudinal direction along the line of the vessels. The lymphatic vessels are spared as much as possible. Any damaged lymph vessels are closed with surgical clips. Damages lymph nodes are either removed or the capsule is sutured to prevent lymph leakage. In case of difficulty with proper access to the femoral arteries, the incision can be extended either medially, laterally, or vertically.

The surgical site complications are defined as follows:

• Surgical site infection according to the Szilagy classification:
• Dehiscence with separation of the wound edges and exposure of the underlying tissue.
• Lymhocele defined as the presence of localized swelling in the groin and verified on ultrasound as an anechoic fluid collection.
• Hematoma defined as the presence of localized swelling in the groin with discoloration and verified on ultrasound as an echoic fluid collection.

Reoperation in the groin due to surgical site complications Reoperation due to the reconstruction Minor or major amputation

Is the patient readmitted due to either surgical site complications or for other reasons