Simultaneous deep inferior epigastric and bilateral anterolateral thigh perforator flap reconstruction of an extended perineoscrotal defect in Fournier's gangrene: A case report

Hideki Kadota, kenta momii, Masuo Hanada, Kenichi Kamizono, yusuke inatomi, Kana Hisanaga, Sei Yoshida, Kippei Ogaki, Keijiro Kiyoshima

Research output: Contribution to journalArticle

1 Citation (Scopus)

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 languageEnglish
Pages (from-to)263-266
Number of pages4
JournalMicrosurgery
Volume39
Issue number3
DOIs
Publication statusPublished - Mar 1 2019

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Fournier Gangrene
Perforator Flap
Thigh
Epigastric Arteries
Perineum
Skin
Transplants
Necrotizing Fasciitis
Surgical Flaps
Buttocks
Scrotum
Genitalia
Groin
Hip Joint
Debridement
Cosmetics
Necrosis
Arteries
Tissue Donors
Wounds and Injuries

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 journalArticle

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