Reconstruction of the Necrotic Scrotum with Hydrosurgery System and Pedicle DIEP Flap: A Case Report of Fournier Gangrene

Makino, Yuma; Matsumine, Hajime; Fujimaki, Hiroshi; Takagi, Mika; Takeuchi, Masaki

doi:10.1097/gox.0000000000003135

Cited by 4 publications

(8 citation statements)

References 10 publications

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“…Penoscrotal O u r l i t e r a t u r e s e a r c h r e t u r n e d f i v e c a s e s s e r i e s (87,(109)(110)(111)(112) on penile reconstruction, after circumcision complications and penile amputation (109,111), for false hermaphroditism (109) (matching chromosomal and gonadal tissue sex, but mismatching external genitalia) and cases of penoscrotal Paget's disease (87,112). For scrotal reconstruction, five articles were included: there were two case series (47,112), a commentary (113), and two case reports on reconstruction after Fournier's gangrene (114,115). One of the cases required coverage of a soft tissue defect measuring 36 cm × 18 cm involving the testes, both sides of the groin, the left medial thigh, and perianal skin.…”

Section: Penoscrotal and Groin Reconstructionmentioning

confidence: 99%

The deep inferior epigastric artery perforator flap: a narrative review on its various uses in non-breast reconstruction

Guinier¹,

Clermont-Tonnerre²,

Tay³

et al. 2023

Ann Transl Med

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Background and Objective: The deep inferior epigastric artery perforator (DIEP) flap was first described by Koshima and Soeda in 1989 and is now well-established as the gold standard in breast reconstruction. Lately, this issue has been explored in the context of head and neck reconstruction, highlighting growing interest in the use of the DIEP flap beyond breast reconstruction, but its usage in other anatomical regions appears elusive. Nevertheless, DIEP flap reconstruction may be a viable choice for complex, three-dimensional head and neck deformities while upholding the criteria of minimal donor site morbidity, according to a recent review. To determine whether the DIEP flap may be used successfully in other types of reconstruction, we conducted a review on the use, applications, and outcomes of the DIEP flap in non-breast reconstruction. This is, as far as we are aware, the first comprehensive analysis of all applications of the DIEP flap other than for breast reconstruction.Methods: A literature review was performed using PubMed to include all relevant articles in English or French published up to February 2022. Keywords included "DIEP flap" and "deep inferior epigastric perforator flap". Key Contents and Findings: A total of 1,299 articles were identified with 105 on the use of the DIEP flap in non-breast reconstruction. This suggests increasing recognition of the DIEP flap as a feasible option for reconstruction of most anatomical regions, especially in lower limb and head and neck reconstruction, followed by gynecological reconstruction. The DIEP flap was also utilized in the reconstruction of upper limb, thigh and hip defects. Less commonly, it has been used for penoscrotal, groin, sternal, buttock and abdomen reconstruction. Conclusions:The scientific body of evidence showed the robustness and versatility of the DIEP flap in non-breast reconstruction, with its relative pros and cons at different anatomical regions.

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Section: Penoscrotal and Groin Reconstructionmentioning

confidence: 99%

The deep inferior epigastric artery perforator flap: a narrative review on its various uses in non-breast reconstruction

Guinier¹,

Clermont-Tonnerre²,

Tay³

et al. 2023

Ann Transl Med

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“…However, using an ultrasonic debridement device enabled us to remove the necrotic tissue and avoid damage to the scrotum, leading to good wound management. Although many reports describe the use of hydraulic debridement devices for Fournier gangrene, 6 reports on the use of ultrasonic debridement devices are lacking.…”

Section: Prs Global Open • 2023mentioning

confidence: 99%

Ultrasonic Debridement of Fournier Gangrene

Tanuma

Ishikawa

Saito

et al. 2023

Plastic and Reconstructive Surgery - Global Open

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Summary: Ultrasonic debridement devices are minimally invasive and effective for biofilm removal, allowing for debridement of necrotic tissue while minimizing damage to normal tissues, such as the blood vessels and nerves. The use of ultrasonic debridement has been reported for foot ulcers and pressure ulcers but not Fournier gangrene. The perineal area, which is difficult to surgically debride using electrocautery, is a suitable site for the use of an ultrasonic debridement device because of its proximity to vital organs. We report here a case of Fournier gangrene that healed with testicular sparing using an ultrasonic debridement device.

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“…3 El cuerpo del pene está compuesto por piel, fascia de Colles, fascia de Buck, vasos y nervios superficiales dorsales, túnica albugínea, tejido eréctil compuesto por cuerpos cavernosos en pares y el cuerpo esponjoso alrededor de la uretra; las quemaduras en esta área anatómica ocasionan graves secuelas funcionales y estéticas. 4 El cirujano plástico que se enfrenta a este escenario clínico debe tener claros los objetivos reconstructivos y enfocarse en lograr una reconstrucción exitosa con la piel y tejido disponible después del desbridamiento. 4,5 Debe también considerar que la quemadura promueve una reacción inflamatoria que, dependiendo de su extensión, puede ser localizada o sistémica.…”

Section: Introductionunclassified