Scrotal Reconstruction Following Fournier Gangrene Using the Medial Circumflex Femoral Artery Perforator Flap

Abstract

Fournier gangrene can have devastating consequences. Often in the male, the testicles become exposed and demand both a functional and esthetic coverage. Local medial thigh cutaneous flaps usually still are available and have evolved to become a preferred solution. The medial circumflex femoral artery perforator (MCFAP) flap based on musculocutaneous perforators of the gracilis muscle represents yet another one of these options. As with all muscle perforator flaps, no muscle need be expended. A case report illustrates the role of the MCFAP flap for creation of a neoscrotum.

Síndrome de Fournier: 10 anos de avaliação

“…Testicle necrosis was rare because of the separate route of blood supply, which is provided by the spermatic vessels 1,6,[23][24][25] . Various types of flaps have been proposed for use in Four nier's syndrome [26][27][28][29] , including the thigh fasciocutaneous flap; it has appropriate thickness, ease of rotation, excellent aesthetic appearance, and rarely undergoes necrosis because of the rich vascularization provided by the internal pudendal and circumflex branches of the femoral artery. Therefore, it is a very safe flap to use, especially in patients with diabetes and vasculopathy.…”

Temporary Relocation of the Testes in Anteromedial Thigh Pouches Facilitates Delayed Primary Scrotal Wound Closure in Fournier Gangrene With Extensive Loss of Scrotal Skin—Experience With 12 Cases

“…Skin grafts may be unsuccesful if graft bed infection is not eliminated, and the eventual cosmetic appearance may not be satisfactory. 16,24 Also, burying the testes in permanent upper medial thigh pouches may be associated with pain, atrophy, impaired testicular temperature regulation, increased predisposition to trauma, and psychological problems. 19 The use of local or free flaps requires expertise which may not readily be available.…”

Aesthetic scrotal reconstruction following extensive Fournier’s gangrene using bilateral island pedicled sensate anterolateral thigh flaps: A case report

“…9,20,22 However, coverage of a 20 × 22-cm defect would be challenging with these techniques. Additionally, this patient's wound tracked posteriorly around the rectum and into the retroperitoneum, with undermining on the left where the pedicle emerges.…”

“…[1][2][3] Several techniques have been described to provide durable coverage, but do not necessarily provide an ideal cosmetic result. [4][5][6][7][8][9][10][11][12][13][14][15] We describe our treatment of a young, healthy male with extensive Fournier's gangrene with loss of the scrotum. Bilateral neurotized anterolateral thigh (ALT) flaps were used to achieve a sensate and aesthetically acceptable result.…”