Scrotal Reconstruction Using Thigh Pedicle Flaps after Scrotal Skin Avulsion

Abstract

Major scrotal and penile skin loss is uncommon and management of such an injury is a challenging problem for genitourinary reconstruction surgeons. Less than 50% scrotal skin loss can often be closed without difficulties immediately after trauma with surrounding tissue. In cases of more significant skin loss, the testes may be preserved by placing them in thigh pouches or dressed with wet dressings until reconstruction, or split thickness skin grafting can be performed. The surgeon’s decision depends on the cause of skin loss – trauma, Fournier‘s gangrene or others. We describe a case of massive scrotal and penile skin loss due to an incident with an agricultural machine. The scrotal reconstruction, performed in three steps, was chosen because of its simplicity, early closure of the wound, excellent cosmetic appearance and maintenance of sexual functions. In the first step the penis was covered with remnant scrotal and preputium skin, and the testes were placed in thigh pouches. Incision of thigh flaps was planned to perform the second step and finally scrotal reconstruction with thigh pedicle flaps was done. Results were satisfactory from an esthetical and functional point of view.

The Effect of Scrotal Reconstruction With Skin Flaps and Skin Grafts on Testicular Function

“…When complete coverage cannot be achieved using residual skin, small skin grafts may be used to cover the residual defects with satisfactory results. 24 In the presence of total scrotal defects, reconstruction is more challenging, and it is still unknown when skin grafts and flaps with different compositions should be used, because each technique is associated with specific advantages and disadvantages. Various techniques have been described in the literature, including the application of skin grafts, skin flaps, musculocutaneous flaps, muscle flaps with skin grafting, and recently, prefabricated omental flaps.…”

Use of a hypogastric flap and split-thickness skin grafting for a degloving injury of the penis and scrotum: A different approach

“…In cases of a more significant skin loss, the testes may be preserved by placing them in thigh pouches or split-thickness skin grafting can be performed. [ 8 ]…”

Use of a hypogastric flap and split-thickness skin grafting for a degloving injury of the penis and scrotum: A different approach

“…In cases of a more significant skin loss, the testes may be preserved by placing them in thigh pouches or split-thickness skin grafting can be performed. [8] Some surgeons prefer staged reconstruction with thigh pedicle flaps. In the case of medial thigh flaps, it involves bilateral subcutaneous elevation of the medial thigh skin and advancing towards the midline where both flaps are sutured to each other.…”