To evaluate the clinical outcomes of paraumbilical perforator flaps with inferior epigastric vessels for the repair of radiation-induced ulcers on the thigh or inguinal regions.

From June 2016 to May 2024，11 patients with radiation-induced thigh or inguinal regions ulcers who met the inclusion criteria were admitted to the Department of Burn and Plastic Surgery of Beijing Jishuitan Hospital，Capital Medical University. There were 5 males and 6 females，aged 40 to 73 years. The wounds were located in the inguinal region in 3 cases and in the middle-upper thigh in 8 cases. After debridement，the wound area ranged from 9 cm×6 cm to 23 cm×10 cm. Paraumbilical perforator flaps with inferior epigastric vessels were used to repair the wounds，with flap area ranging from 15 cm×8 cm to 28 cm×14 cm. The donor sites were all closed by direct approximation after flap transfer. Postoperative flap survival，wound healing，and donor site complications were observed. Preoperative and intraoperative bacterial culture results of wound tissue specimens and pathological results of ulcer tissue specimens were recorded.

Bacterial cultures of wound tissue were negative in 1 case and positive in 10 cases. Among the positive cases，5 had monomicrobial infection and 5 had polymicrobial infection （≥2 bacterial species）. During postoperative follow-up of 6 to 24 months，7 flaps survived completely with primary wound healing； 2 flaps developed distal marginal necrosis and healed after revision surgery； 2 flaps survived completely but with persistent sinus tracts，which healed after dressing changes or surgical debridement. All donor sites healed primarily，with no complications such as abdominal wall hernia observed.

The paraumbilical perforator flap with inferior epigastric vessels is characterized by reliable blood supply，adequate tissue volume，and long vascular pedicle. It is an effective technique for the repair of radiation-induced ulcers on the thigh or inguinal regions.