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 ◽  
...  
2021 ◽  
Vol 14 (4) ◽  
pp. e240618
Author(s):  
Justin Hart ◽  
Jeffrey DeSano ◽  
Raymond Hajjar ◽  
Christopher Lumley

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.


2012 ◽  
Vol 2012 ◽  
pp. 1-3 ◽  
Author(s):  
Jason D. Heiner ◽  
Katisha D. Eng ◽  
Todd A. Bialowas ◽  
Diane Devita

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.


2021 ◽  
Vol 206 (Supplement 3) ◽  
Author(s):  
Hayden Warner ◽  
Blaize Kandler ◽  
Shawn Sexton ◽  
Jason Sandberg ◽  
Jacob Oleson ◽  
...  

2020 ◽  
Vol 6 ◽  
pp. 2513826X2096413
Author(s):  
Anna Duncan ◽  
Stephanie Byun ◽  
Justin Paletz

Fournier’s gangrene is a necrotizing infection of the soft tissue structures of the perineum that can extend quickly, requiring aggressive and repeated surgical debridement. This can result in extensive tissue loss and functional impairment, creating reconstructive challenges for plastic surgeons. We present a case of Fournier’s gangrene which resulted in complete loss of the pelvic floor musculature and functional loss of the urinary and fecal outlets. Given the extent of the defect and involvement of areas that would traditionally be used as donor site for local and regional flaps, reconstruction was sought with a free latissimus dorsi flap in combination with split-thickness skin grafting following serial debridement and negative pressure wound therapy. The patient survived and made a satisfactory recovery.


Burns ◽  
2003 ◽  
Vol 29 (8) ◽  
pp. 857-862 ◽  
Author(s):  
Pirko Maguiña ◽  
Tina L Palmieri ◽  
David G Greenhalgh

2013 ◽  
Vol 7 (7-8) ◽  
pp. 481 ◽  
Author(s):  
Oleg Akilov ◽  
Alexandre Pompeo ◽  
David Sehrt ◽  
Paul Bowlin ◽  
Wilson R Molina ◽  
...  

Objective: We report the outcomes of an early loose closure of the scrotum with a modified U-stitch to minimize use of split-thickens skin graft for patients with hemiscrotal tissue loss after surgical debridement.Methods: From January 2006 to August 2011, 28 male patients presented with Fournier’s gangrene, requiring major urological surgical care and scrotal debridement at Denver Health Medical Center. Surgical outcomes were compared between patients receiving a novel U-Stitch approximation and those treated by traditional management.Results: The mean age of the patients was 47.1 ± 10.2 years. In total 8 patients (2.2%) developed bacteremia and 3 (0.1%) had methicillin-resistant staphylococcus aureus (MRSA) infection. There was conversion from the U-Stitch approximation patients to traditional management. U-stitch patients required less hospitalization than patients requiring split-thickness skin graft (STSG) due to loss of >50% of the total scrotal tissue (11 vs. 35 days, p = 0.081). The U-stitch demonstrated non-inferiority to traditional treatment.Conclusion: Immediate loose scrotal wound approximation with efficient surgical debridement for Fournier’s gangrene may prevent testis exposure facilitating local wound treatment, decreasing the length of hospital stay in patients with Fournier’s gangrene involving the scrotum. Future randomized trials may validate these findings.


1994 ◽  
Vol 17 (5) ◽  
Author(s):  
P. Schaller ◽  
Z. Akcetin ◽  
R. K�hn ◽  
C. Radu ◽  
J. Geldmacher

Diabetes ◽  
2018 ◽  
Vol 67 (Supplement 1) ◽  
pp. 111-OR
Author(s):  
ELLIOT WALTERS ◽  
GREG STIMAC ◽  
NEHA RAJPAL ◽  
IRAM NAZ ◽  
TAMMER ELMARSAFI ◽  
...  

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