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Reconstruction of perineoscrotal defects in F ournier's gangrene with pedicle anterolateral thigh perforator flap
Author(s) -
Lin ChinTa,
Chang ShunCheng,
Chen ShyiGen,
Tzeng YuanSheng
Publication year - 2016
Publication title -
anz journal of surgery
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.426
H-Index - 70
eISSN - 1445-2197
pISSN - 1445-1433
DOI - 10.1111/ans.12782
Subject(s) - medicine , surgery , perforator flaps , scrotum , gangrene , perineum , fasciitis , hematoma , thigh , cosmesis , plastic surgery , fournier gangrene , reconstructive surgery , debridement (dental) , soft tissue , necrotising fasciitis
Abstract Background Fournier's gangrene is an acute and potentially lethal necrotizing fasciitis that involves the scrotum and perineum. This disease can result in the extensive loss of skin and soft tissues of the perineoscrotal area with exposure of the testes. To reconstruct the large defects of scrotal and perineal remains a surgical challenge. Methods Between J anuary 2008 and D ecember 2012, 26 patients were admitted with a diagnosis of F ournier's gangrene. The D ivision of P lastic and R econstructive S urgery at our hospital was consulted about patients who needed reconstructive procedures after initial debridement was performed in the D ivision of C olorectal S urgery or the D ivision of U rology. Of the 26 patients, 10 patients with large perineoscrotal defects who underwent the reconstructive surgery using pedicle anterolateral thigh ( ALT ) perforator flaps were enrolled in this series. Results We carried out the perineoscrotal reconstruction in these 10 patients using the pedicled ALT perforator flaps. They were all male with a mean age of 59.1 years (ranged from 39 to 82 years). The size of the flaps ranged from 72 to 198 cm 2 . All flaps survived completely but one hematoma was noticed postoperatively. All patients mobilized well with no limitation of motion, and the scrotal contour appeared to be natural. Conclusion Early debridement and wound coverage in F ournier's gangrene are mandatory to allow patients to return to normal life. Pedicle ALT perforator flaps provide pliable and reliable soft‐tissue coverage for large perineoscrotal defects with adequate contour that result in satisfactory function and cosmesis.