Simultaneous deep inferior epigastric and bilateral anterolateral thigh perforator flap reconstruction of an extended perineoscrotal defect in Fournier's gangrene: A case report

Achieving an aesthetic appearance of the scrotum after extensive Fournier’s gangrene is a reconstructive challenge. Testicular coverage is often prioritized over scrotal cosmesis due to the comorbidities typically seen in this patient population. We describe our treatment of a young, healthy male with extensive Fournier’s gangrene, with loss of the scrotum. Bilateral neurotized anterolateral thigh flaps were used to achieve a sensate and aesthetically acceptable result.

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

ANZ Journal of Surgery ◽

10.1111/ans.12782 ◽

2014 ◽

Vol 86 (12) ◽

pp. 1052-1055 ◽

Cited By ~ 9

Author(s):

Chin-Ta Lin ◽

Shun-Cheng Chang ◽

Shyi-Gen Chen ◽

Yuan-Sheng Tzeng

Keyword(s):

Perforator Flap ◽

Fournier’S Gangrene ◽

Fournier's Gangrene ◽

Anterolateral Thigh

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Fournier's gangrene as Amyand's hernia complication

Perspectives in Surgery ◽

10.33699/pis.2019.98.7.291-296 ◽

2019 ◽

Vol 98 (7) ◽

pp. 291-296

Keyword(s):

Case Report ◽

Case Reports ◽

Rare Condition ◽

Sporadic Case ◽

Fournier’S Gangrene ◽

Amyand’S Hernia ◽

Fournier's Gangrene ◽

Randomized Controlled Studies ◽

Based Medicine ◽

Hernia Complication

Introduction: Fournier’s gangrene is a rare but fast deteriorating and serious condition with high mortality. In most cases, it is characterized as necrotizing fasciitis of the perineum and external genitals. Amyand’s hernia is a rare condition where the appendix is contained in the sac of an inguinal hernia. Inflammatory alterations in the appendix account only for 0.1 % of the cases when Amyand’s hernia is verified. Fournier’s gangrene as a complication of a late diagnosis of appendicitis located in the inguinal canal is described in the literature as rare case reports. Case report: The case report of a 70-year-old patient with Fournier’s gangrene resulting from gangrenous appendicitis of Amyand’s hernia. Conclusion: Fournier’s gangrene as a complication of Amyand’s hernia is a rare condition. Only sporadic case reports thereof can be found in the literature. Because of the rarity of this pathology and the lack of randomized controlled studies, it is difficult to determine the optimal treatment according to the principles of evidence-based medicine. An appropriate approach for this condition appears to be the combination of guidelines developed in Amyand’s therapy according to Losanoff and Basson, along with the recommended “gold standard” therapy for Fournier’s gangrene. This means early and highly radical surgical debridement, adequate antibiotic therapy and intensive care.

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Reconstruction of perineo-scrotal defects from Fournier’s gangrene with the adipofascial anterolateral thigh flap

Journal of Clinical Urology ◽

10.1177/2051415814537821 ◽

2014 ◽

Vol 8 (1) ◽

pp. 33-37

Author(s):

O Onyekwelu ◽

A Reid ◽

DA McGrouther

Keyword(s):

Fournier’S Gangrene ◽

Anterolateral Thigh Flap ◽

Fournier's Gangrene ◽

Anterolateral Thigh

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Fournier’s gangrene secondary to male’s circumcision – a case report and review of the literature

Acta Chirurgiae Plasticae ◽

10.48095/ccachp202196 ◽

2021 ◽

Vol 63 (3) ◽

Author(s):

Massimiliano Tripoli ◽

Emanuele Cammarata ◽

Adriana Cordova

Keyword(s):

Case Report ◽

Fournier’S Gangrene ◽

Review Of The Literature ◽

Fournier's Gangrene

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Perineoscrotal reconstruction following fournier's gangrene using the upper medial thigh perforator flap

Turkish Journal of Plastic Surgery ◽

10.4103/tjps.tjps_82_18 ◽

2019 ◽

Vol 0 (0) ◽

pp. 0

Author(s):

Mert Sizmaz ◽

Fatih Irmak ◽

SelamiSerhat Sirvan ◽

SevgiKurt Yazar ◽

Arzu Akcal ◽

...

Keyword(s):

Perforator Flap ◽

Fournier’S Gangrene ◽

Fournier's Gangrene ◽

Medial Thigh

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Fournier's Gangrene of Genitalia: Case Report

Urologia Journal ◽

10.1177/039156030307001-408 ◽

2003 ◽

Vol 70 (1-4) ◽

pp. 38-40

Author(s):

P. Salciccia ◽

G. Poveromo ◽

S. Salciccia

Keyword(s):

Septic Shock ◽

Case Report ◽

Early Diagnosis ◽

Rare Disease ◽

Abdominal Wall ◽

Sudden Onset ◽

Fournier’S Gangrene ◽

Fournier's Gangrene ◽

Prodromal Symptoms

Fournier's gsngrene is a rare disease involving the scrotum and the penis with occasional extension up to the abdominal wall. The etiology of the disease, commonly without prodromal symptoms and with sudden onset, is still not fully understood. The organisms are usually streptococcus haemoliticus and/or anerobic bacteria. We report a case of Fournier's gangrene, presenting septic shock. The patient was treated with reanimatory care, antibiotics, local excision and debridment. Speaking about anatomical and etiopathogenetic hypotheses, we discuss the diagnostic problems and the treatment of the disease. We emphasize the role of the early diagnosis.

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