RESUMEN
Introduction : Fournier抯 Gangrene is a rapidly progressive necrotising faciitis affecting the genital region, perineum, perianal region and the abdominal wall. It can have an adverse effect on the functional and psychological aspects of the patient. Many flaps are available for the defect coverage. Aim : The aim of this prospective study was to analyse the effectiveness of laterally based medial thigh flap for scrotal reconstruction. This is a fasciocutaneous flap just below the Scrotum which covers moderate to large sized scrotal defects successfully. Methods and Materials : This study was done at a teaching hospital in South India on patients with major scrotal defects secondary to Fournier抯 Gangrene. Ten patients with major scrotal defects secondary to Fournier抯 gangrene were subjected to reconstruction of scrotum by medial thigh fasciocutaneous flap. Results and Conclusions : All ten flaps survived and provided a durable and aesthetic cover for exposed testes. Only one flap had necrosis of distal 2cm, which was successfully managed by secondary suturing. The donor areas were primarily covered with placement of a small graft near the base of the flap, which healed well with an inconspicuous scar. In conclusion, the laterally based medial thigh fasciocutaneous flap provides excellent closure for extensive scrotal skin loss. It is a robust flap, easy to mobilise, rarely undergoes necrosis, provides a sensate cover with excellent aesthetic results. The technique is simple, less time consuming and can be easily incorporated by plastic Surgeons and General Surgeons
RESUMEN
Fournier’s gangrene is a rare, idiopathic, life-threatening, necrotizing fasciitis of the genitals and perineum caused by both aerobic and anaerobic bacterial flora. The synergistic effect of the bacteriae results in fulminating gangrene, multiple organ failure, and can even lead to death. Most commonly it has a predilection for diabetic and alcohol abused individuals, those who have impaired immunity. Genital trauma is frequently recognized vector for infection initiation. Timely recognition of the disease process and initiation of treatment with aggressive debridement and antibiotic administration is called for. The advanced age of the patient, extensive disease, delayed presentation with shock or sepsis and organ failures, all contribute to mortality in Fournier’s gangrene. In this case report, we recall an account of our tryst with Fournier’s gangrene management.
RESUMEN
A technique is described for reconstructing the scrotum in patient who was diagnosed as male pseudohermaphroditism. Scrotal reconstruction with skin flap and silicone prosthesis was done in 3-year old child and had acceptable cosmetic result. Herein we present a case of scrotal reconstruction with some literature.