Abstract
Fournier's gangrene is lethal necrotizing fasciitis that involves the perineum and external genitalia. We describe the case of a 52-year-old man with Fournier's gangrene who underwent reconstruction of an extensive perineoscrotal defect using three pedicled perforator flaps. Three debridement procedures resulted in a skin and soft tissue defect of 36 × 18 cm involving the perineum, scrotum, groin, medial thigh, buttocks, and circumferential perianal area and left the perforating arteries originating from these locations unavailable for reconstruction. We repaired the defect using left deep inferior epigastric artery perforator (DIEP) (29 × 8 cm) and bilateral anterolateral thigh perforator (ALT) flaps (35 × 8 cm and 22 × 7 cm). The flaps reached the defect without tension, and the defect was successfully covered without a skin graft. No postoperative complications occurred except for epidermal necrosis involving a tiny part of the DIEP flap tip. Nine months postoperatively, the patient experienced no impairment of bowel function or hip joint movement. There was also no avulsion or ulceration of the reconstructed perineal skin, and the cosmetic appearances of the healed wound and donor site were satisfactory. The combination of these three perforator flaps enabled us to achieve a satisfactory outcome while avoiding skin grafts.
| Original language | English |
|---|---|
| Pages (from-to) | 263-266 |
| Number of pages | 4 |
| Journal | Microsurgery |
| Volume | 39 |
| Issue number | 3 |
| DOIs | |
| Publication status | Published - Mar 1 2019 |
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All Science Journal Classification (ASJC) codes
- Surgery
Cite this
Simultaneous deep inferior epigastric and bilateral anterolateral thigh perforator flap reconstruction of an extended perineoscrotal defect in Fournier's gangrene : A case report. / Kadota, Hideki; momii, kenta; Hanada, Masuo; Kamizono, Kenichi; inatomi, yusuke; Hisanaga, Kana; Yoshida, Sei; Ogaki, Kippei; Kiyoshima, Keijiro.
In: Microsurgery, Vol. 39, No. 3, 01.03.2019, p. 263-266.Research output: Contribution to journal › Article
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TY - JOUR
T1 - Simultaneous deep inferior epigastric and bilateral anterolateral thigh perforator flap reconstruction of an extended perineoscrotal defect in Fournier's gangrene
T2 - A case report
AU - Kadota, Hideki
AU - momii, kenta
AU - Hanada, Masuo
AU - Kamizono, Kenichi
AU - inatomi, yusuke
AU - Hisanaga, Kana
AU - Yoshida, Sei
AU - Ogaki, Kippei
AU - Kiyoshima, Keijiro
PY - 2019/3/1
Y1 - 2019/3/1
N2 - Fournier's gangrene is lethal necrotizing fasciitis that involves the perineum and external genitalia. We describe the case of a 52-year-old man with Fournier's gangrene who underwent reconstruction of an extensive perineoscrotal defect using three pedicled perforator flaps. Three debridement procedures resulted in a skin and soft tissue defect of 36 × 18 cm involving the perineum, scrotum, groin, medial thigh, buttocks, and circumferential perianal area and left the perforating arteries originating from these locations unavailable for reconstruction. We repaired the defect using left deep inferior epigastric artery perforator (DIEP) (29 × 8 cm) and bilateral anterolateral thigh perforator (ALT) flaps (35 × 8 cm and 22 × 7 cm). The flaps reached the defect without tension, and the defect was successfully covered without a skin graft. No postoperative complications occurred except for epidermal necrosis involving a tiny part of the DIEP flap tip. Nine months postoperatively, the patient experienced no impairment of bowel function or hip joint movement. There was also no avulsion or ulceration of the reconstructed perineal skin, and the cosmetic appearances of the healed wound and donor site were satisfactory. The combination of these three perforator flaps enabled us to achieve a satisfactory outcome while avoiding skin grafts.
AB - Fournier's gangrene is lethal necrotizing fasciitis that involves the perineum and external genitalia. We describe the case of a 52-year-old man with Fournier's gangrene who underwent reconstruction of an extensive perineoscrotal defect using three pedicled perforator flaps. Three debridement procedures resulted in a skin and soft tissue defect of 36 × 18 cm involving the perineum, scrotum, groin, medial thigh, buttocks, and circumferential perianal area and left the perforating arteries originating from these locations unavailable for reconstruction. We repaired the defect using left deep inferior epigastric artery perforator (DIEP) (29 × 8 cm) and bilateral anterolateral thigh perforator (ALT) flaps (35 × 8 cm and 22 × 7 cm). The flaps reached the defect without tension, and the defect was successfully covered without a skin graft. No postoperative complications occurred except for epidermal necrosis involving a tiny part of the DIEP flap tip. Nine months postoperatively, the patient experienced no impairment of bowel function or hip joint movement. There was also no avulsion or ulceration of the reconstructed perineal skin, and the cosmetic appearances of the healed wound and donor site were satisfactory. The combination of these three perforator flaps enabled us to achieve a satisfactory outcome while avoiding skin grafts.
UR - http://www.scopus.com/inward/record.url?scp=85060350781&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=85060350781&partnerID=8YFLogxK
U2 - 10.1002/micr.30409
DO - 10.1002/micr.30409
M3 - Article
C2 - 30666712
AN - SCOPUS:85060350781
VL - 39
SP - 263
EP - 266
JO - Microsurgery
JF - Microsurgery
SN - 0738-1085
IS - 3
ER -