Reconstruction of perineoscrotal defects in Fournier's gangrene with pedicle anterolateral thigh perforator flap

Chin Ta Lin, Shun Cheng Chang, Shyi Gen Chen, Yuan Sheng Tzeng

Research output: Contribution to journalArticle

9 Citations (Scopus)

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 January 2008 and December 2012, 26 patients were admitted with a diagnosis of Fournier's gangrene. The Division of Plastic and Reconstructive Surgery at our hospital was consulted about patients who needed reconstructive procedures after initial debridement was performed in the Division of Colorectal Surgery or the Division of Urology. 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 cm2. 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 Fournier'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.

Original languageEnglish
Pages (from-to)1052-1055
Number of pages4
JournalANZ Journal of Surgery
Volume86
Issue number12
DOIs
Publication statusPublished - Dec 1 2016
Externally publishedYes

Fingerprint

Fournier Gangrene
Perforator Flap
Thigh
Reconstructive Surgical Procedures
Debridement
Necrotizing Fasciitis
Perineum
Colorectal Surgery
Scrotum
Urology
Plastic Surgery
Hematoma
Testis
Skin
Wounds and Injuries

Keywords

  • Fournier's gangrene
  • pedicle anterolateral thigh flap
  • perineoscrotal defect
  • reconstruction

ASJC Scopus subject areas

  • Surgery

Cite this

Reconstruction of perineoscrotal defects in Fournier's gangrene with pedicle anterolateral thigh perforator flap. / Lin, Chin Ta; Chang, Shun Cheng; Chen, Shyi Gen; Tzeng, Yuan Sheng.

In: ANZ Journal of Surgery, Vol. 86, No. 12, 01.12.2016, p. 1052-1055.

Research output: Contribution to journalArticle

@article{a06b138c6e8d41a3a5f31318472241d2,
title = "Reconstruction of perineoscrotal defects in Fournier's gangrene with pedicle anterolateral thigh perforator flap",
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 January 2008 and December 2012, 26 patients were admitted with a diagnosis of Fournier's gangrene. The Division of Plastic and Reconstructive Surgery at our hospital was consulted about patients who needed reconstructive procedures after initial debridement was performed in the Division of Colorectal Surgery or the Division of Urology. 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 cm2. 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 Fournier'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.",
keywords = "Fournier's gangrene, pedicle anterolateral thigh flap, perineoscrotal defect, reconstruction",
author = "Lin, {Chin Ta} and Chang, {Shun Cheng} and Chen, {Shyi Gen} and Tzeng, {Yuan Sheng}",
year = "2016",
month = "12",
day = "1",
doi = "10.1111/ans.12782",
language = "English",
volume = "86",
pages = "1052--1055",
journal = "ANZ Journal of Surgery",
issn = "1445-1433",
publisher = "Blackwell Publishing",
number = "12",

}

TY - JOUR

T1 - Reconstruction of perineoscrotal defects in Fournier's gangrene with pedicle anterolateral thigh perforator flap

AU - Lin, Chin Ta

AU - Chang, Shun Cheng

AU - Chen, Shyi Gen

AU - Tzeng, Yuan Sheng

PY - 2016/12/1

Y1 - 2016/12/1

N2 - 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 January 2008 and December 2012, 26 patients were admitted with a diagnosis of Fournier's gangrene. The Division of Plastic and Reconstructive Surgery at our hospital was consulted about patients who needed reconstructive procedures after initial debridement was performed in the Division of Colorectal Surgery or the Division of Urology. 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 cm2. 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 Fournier'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.

AB - 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 January 2008 and December 2012, 26 patients were admitted with a diagnosis of Fournier's gangrene. The Division of Plastic and Reconstructive Surgery at our hospital was consulted about patients who needed reconstructive procedures after initial debridement was performed in the Division of Colorectal Surgery or the Division of Urology. 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 cm2. 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 Fournier'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.

KW - Fournier's gangrene

KW - pedicle anterolateral thigh flap

KW - perineoscrotal defect

KW - reconstruction

UR - http://www.scopus.com/inward/record.url?scp=84904522246&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=84904522246&partnerID=8YFLogxK

U2 - 10.1111/ans.12782

DO - 10.1111/ans.12782

M3 - Article

C2 - 25056663

AN - SCOPUS:84904522246

VL - 86

SP - 1052

EP - 1055

JO - ANZ Journal of Surgery

JF - ANZ Journal of Surgery

SN - 1445-1433

IS - 12

ER -