Scrotal reconstruction after Fournier's gangrene with simple skin grafting

1994 ◽  
Vol 17 (5) ◽  
Author(s):  
P. Schaller ◽  
Z. Akcetin ◽  
R. K�hn ◽  
C. Radu ◽  
J. Geldmacher
Keyword(s):  
Skin Grafting ◽  
Fournier’S Gangrene ◽  
Fournier's Gangrene ◽  
Scrotal Reconstruction

Split-thickness skin grafting: A modest technique for scrotal reconstruction in patients of Fournier’s gangrene

2019 ◽  
Vol 15 (1) ◽  
pp. 9
Author(s):  
RajeshK Maurya ◽  
Imran Ahmad ◽  
MohammedF Khurram ◽  
Brajesh Pathak ◽  
AliA Mahmud ◽  
...  
Keyword(s):  
Skin Grafting ◽  
Fournier’S Gangrene ◽  
Fournier's Gangrene ◽  
Thickness Skin ◽  
Split Thickness Skin Grafting ◽  
Scrotal Reconstruction

Total scrotal reconstruction following Fournier’s gangrene with bilateral prelaminated superior medial thigh flaps

2021 ◽  
Vol 14 (4) ◽  
pp. e240618
Author(s):  
Justin Hart ◽  
Jeffrey DeSano ◽  
Raymond Hajjar ◽  
Christopher Lumley
Keyword(s):  
Muscle Flap ◽  
Skin Grafting ◽  
Fournier’S Gangrene ◽  
Ischiorectal Fossa ◽  
Fournier's Gangrene ◽  
Dermal Matrix ◽  
Gracilis Muscle Flap ◽  
Medial Thigh ◽  
Split Thickness Skin Grafting ◽  
Scrotal Reconstruction

The patient is a 45-year-old man diagnosed with Fournier’s gangrene and underwent treatment for septic shock, broad-spectrum antibiotic therapy and extensive surgical debridement of perineum, including total scrotectomy, ischiorectal fossa, abdomen and left superior thigh and flank. The patient required multiple staged complex reconstruction of the scrotum utilising prelaminated superior medial thigh flaps with use of dermal matrix, split-thickness skin grafting and pedicled gracilis muscle flap for coverage of the ischiorectal wound. The patient had full recovery and followed up 1 year postoperatively. This report discusses our technique for total scrotal reconstruction and provides review of surgical reconstructive techniques for wounds due to Fournier’s gangrene.

scholarly journals Fournier’s gangrene: a retrospective review of management outcomes and seasonal variations of clinical presentation

2021 ◽  
Vol 27 (1) ◽  
Author(s):  
Ikenna I. Nnabugwu ◽  
Okechukwu O. Onumaegbu ◽  
Louis T. Okolie
Keyword(s):  
Hospital Admission ◽  
Seasonal Variations ◽  
Medical Records ◽  
Vital Signs ◽  
Skin Grafting ◽  
Severity Index ◽  
Fournier’S Gangrene ◽  
Fournier's Gangrene ◽  
Management Interventions ◽  
Split Skin Grafting

Abstract Background To review retrospectively the outcomes of management of Fournier’s gangrene (FG) and to assess for possible seasonal variations in clinical presentations of FG to a referral hospital in a tropical African country. Methods The medical records of patients who presented with FG from February 2012 to December 2019 were reviewed. Of interest were age of patient, vital signs at presentation, site of gangrene, duration of hospital admission, and management interventions deployed. Analysis was with SPSS® version 21. Results Twenty-three of 28 medical records could be analyzed. Median Fournier’s Gangrene Severity Index (FGSI) was 5 (IQR:3–10), the median Uludag-FGSI (UFGSI) was 7 (IQR:4–14). In 82.6%, the scrotum was the site of onset; in 8.7%, the lesion had spread beyond the pelvis. Diabetes mellitus (30.4%), HIV infection (13.0%) and nephropathy (17.4%) were identified co-morbidities. There were 2.4 ± 1.0 debridement sessions and 1.5 ± 1.3 transfused units of blood per patient. In 60.9%, the wound edges were undermined and apposed; in 17.4%, split skin grafting or fascio-cutaneous flap cover was deployed. In 17.4%, satisfactory wound closure needed more than 1 theater session. Mean duration of hospital admission was 51.4 ± 19.4 days. No mortality was recorded. Majority (91.2%) presented in hot, dry months of October through March with peak in December. No case presented in the wet months of May through September. Conclusion Meager resources notwithstanding, FG management outcomes are generally satisfactory. Furthermore, FG is observed to present mostly in the hot, dry months of the year in the 8 years under review.

scholarly journals A Rare Case of Idiophatic Fournier’s Gangrene: Scrotal Reconstruction via Anterolateral Thigh Flap

2021 ◽  
Vol 7 ◽  
pp. 2513826X2110289
Author(s):  
Tomas Mačiulaitis ◽  
Nerijus Jakutis ◽  
Karolis Baužys
Keyword(s):  
Unusual Case ◽  
Treatment Plan ◽  
Fournier’S Gangrene ◽  
Anterolateral Thigh Flap ◽  
Soft Tissue Defects ◽  
Healthy Male ◽  
Fournier's Gangrene ◽  
Anterolateral Thigh ◽  
Scrotal Reconstruction ◽  
Tissue Defects

Fournier’s gangrene (FG) is a surgical emergency. The main treatment plan for this disease includes several aggressive debridements, which lead to the development of massive soft-tissue defects in the affected area. Current literature describes various possible reconstructive options for the closure of those defects, yet, there is no evidence on which is the most efficient. Here we describe an unusual case of an otherwise healthy male presenting with a scrotal Fournier’s gangrene. In our case, the reconstruction was performed via anterolateral thigh flap. Due to a postoperative complication the flap was partly lost, however, consequences were managed successfully and a satisfactory result was achieved.

scholarly journals New Methods of Reconstruction for Old Challenges: The Use of the Integra Graft in Necrotizing Soft Tissue Infections of the Male Genitalia

2021 ◽  
Vol 2021 ◽  
pp. 1-5
Author(s):  
Katharina Mitchell ◽  
Chad Crigger ◽  
Chad Morley ◽  
John Barnard ◽  
Vidas Dumasius
Keyword(s):  
Soft Tissue ◽  
Case Series ◽  
External Genitalia ◽  
Skin Grafting ◽  
Fournier’S Gangrene ◽  
Fournier's Gangrene ◽  
Bovine Collagen ◽  
Necrotizing Soft Tissue Infections ◽  
Perineal Region ◽  
Methods Of Reconstruction

In this paper, we describe two cases of Fournier’s gangrene (FG) in which Integra grafting was used for reconstruction. FG is a progressive necrotizing infection occurring in the perineal region and on the external genitalia. Reconstructive options using local tissue are limited due to the destruction this infection imposes on the soft tissue. Integra graft is a bilaminate artificial dermis made of shark chondroitin 6-sulfate and bovine collagen. It is applied to the wound bed after debridement and establishment of a healthy, well-vascularized wound base. The patients in this case series had large defects which could not be closed primarily with tissue beds and would not have been appropriate for skin grafting. Therefore, an Integra graft was placed. In both patients, the wound beds were appropriate for skin grafting after three weeks. Without the Integra graft, both of our patients would have needed to wait a considerable amount of time prior to reconstruction. Our case series further illustrates and supports the use of Integra grafts in such a scenario following Fournier’s gangrene which has only previously been published on three occasions, all of which demonstrated successful outcomes.

scholarly journals Fournier's Gangrene due to Masturbation in an Otherwise Healthy Male

2012 ◽  
Vol 2012 ◽  
pp. 1-3 ◽  
Author(s):  
Jason D. Heiner ◽  
Katisha D. Eng ◽  
Todd A. Bialowas ◽  
Diane Devita
Keyword(s):  
Unusual Case ◽  
Skin Grafting ◽  
Fournier’S Gangrene ◽  
Healthy Male ◽  
Fournier's Gangrene ◽  
Scrotal Pain ◽  
Thickness Skin ◽  
Intravenous Antibiotics ◽  
Split Thickness Skin Grafting ◽  
Life Threatening

Fournier's gangrene is a rare and often fulminant necrotizing fasciitis of the perineum and genital region frequently due to a synergistic polymicrobial infection. This truly emergent condition is typically seen in elderly, diabetic, or otherwise immune-compromised individuals. Here, we report an unusual case of Fournier's gangrene due to excessive masturbation in an otherwise healthy 29-year-old male who presented to the emergency department complaining of two days of fever, vomiting, and diffuse myalgias. Upon further questioning, he also endorsed severe scrotal pain and swelling and frequent masturbation with soap as a lubricant resulting in recurrent penile erythema and minor skin abrasions. Examination of the patient's perineum was consistent with Fournier's gangrene and included significant erythema, edema, and calor of the penis and scrotum with a large malodorous eschar. He was given intravenous antibiotics and immunoglobulin and promptly underwent three surgical debridements of the scrotum and penis with split-thickness skin grafting. Complications from excessive masturbation are exceedingly rare, but as this case illustrates, they can be life threatening.

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