Bilateral pedicle anterolateral thigh (ALT) flap combined with bilateral sartorius muscle flap for reconstruction of extensive perineoscrotal and medial thigh defect because of Fournier's gangrene

Microsurgery ◽  
2016 ◽  
Vol 37 (6) ◽  
pp. 669-673 ◽  
Author(s):  
Mario F. Scaglioni ◽  
Richard M. Fakin ◽  
Andrè A. Barth ◽  
Pietro Giovanoli
Keyword(s):  
Muscle Flap ◽  
Fournier’S Gangrene ◽  
Sartorius Muscle ◽  
Fournier's Gangrene ◽  
Medial Thigh ◽  
Anterolateral Thigh ◽  
Alt Flap ◽  
Thigh Defect

Total scrotal reconstruction following Fournier’s gangrene with bilateral prelaminated superior medial thigh flaps

2021 ◽  
Vol 14 (4) ◽  
pp. e240618
Author(s):  
Justin Hart ◽  
Jeffrey DeSano ◽  
Raymond Hajjar ◽  
Christopher Lumley
Keyword(s):  
Muscle Flap ◽  
Skin Grafting ◽  
Fournier’S Gangrene ◽  
Ischiorectal Fossa ◽  
Fournier's Gangrene ◽  
Dermal Matrix ◽  
Gracilis Muscle Flap ◽  
Medial Thigh ◽  
Split Thickness Skin Grafting ◽  
Scrotal Reconstruction

The patient is a 45-year-old man diagnosed with Fournier’s gangrene and underwent treatment for septic shock, broad-spectrum antibiotic therapy and extensive surgical debridement of perineum, including total scrotectomy, ischiorectal fossa, abdomen and left superior thigh and flank. The patient required multiple staged complex reconstruction of the scrotum utilising prelaminated superior medial thigh flaps with use of dermal matrix, split-thickness skin grafting and pedicled gracilis muscle flap for coverage of the ischiorectal wound. The patient had full recovery and followed up 1 year postoperatively. This report discusses our technique for total scrotal reconstruction and provides review of surgical reconstructive techniques for wounds due to Fournier’s gangrene.

Perineoscrotal reconstruction following fournier's gangrene using the upper medial thigh perforator flap

2019 ◽  
Vol 0 (0) ◽  
pp. 0
Author(s):  
Mert Sizmaz ◽  
Fatih Irmak ◽  
SelamiSerhat Sirvan ◽  
SevgiKurt Yazar ◽  
Arzu Akcal ◽  
...  
Keyword(s):  
Perforator Flap ◽  
Fournier’S Gangrene ◽  
Fournier's Gangrene ◽  
Medial Thigh

scholarly journals A Rare Case of Idiophatic Fournier’s Gangrene: Scrotal Reconstruction via Anterolateral Thigh Flap

2021 ◽  
Vol 7 ◽  
pp. 2513826X2110289
Author(s):  
Tomas Mačiulaitis ◽  
Nerijus Jakutis ◽  
Karolis Baužys
Keyword(s):  
Unusual Case ◽  
Treatment Plan ◽  
Fournier’S Gangrene ◽  
Anterolateral Thigh Flap ◽  
Soft Tissue Defects ◽  
Healthy Male ◽  
Fournier's Gangrene ◽  
Anterolateral Thigh ◽  
Scrotal Reconstruction ◽  
Tissue Defects

Fournier’s gangrene (FG) is a surgical emergency. The main treatment plan for this disease includes several aggressive debridements, which lead to the development of massive soft-tissue defects in the affected area. Current literature describes various possible reconstructive options for the closure of those defects, yet, there is no evidence on which is the most efficient. Here we describe an unusual case of an otherwise healthy male presenting with a scrotal Fournier’s gangrene. In our case, the reconstruction was performed via anterolateral thigh flap. Due to a postoperative complication the flap was partly lost, however, consequences were managed successfully and a satisfactory result was achieved.

scholarly journals Scrotal reconstruction with pedicled gracilis muscle flap following Fournier’s gangrene: a case report and literature review

2021 ◽  
Vol 27 (1) ◽  
Author(s):  
Oluwatosin Stephen Ilori ◽  
David. A. Onilede ◽  
Ademola. A. Popoola ◽  
Olorunnisola O. Olatide ◽  
Chidi O. Ugwuoke
Keyword(s):  
Donor Site ◽  
Outlet Obstruction ◽  
Muscle Flap ◽  
External Genitalia ◽  
Donor Site Morbidity ◽  
Fournier’S Gangrene ◽  
Gracilis Muscle ◽  
Fournier's Gangrene ◽  
Additional Advantage ◽  
Gracilis Muscle Flap

Abstract Background Fournier’s gangrene is an acute soft tissue necrotizing infection involving the perineum and the external genitalia which can result in a major loss of the scrotal wall with exposure of the testicles. Reconstruction of such major defect is quite challenging; the use of pedicled gracilis muscle flap helps to create an aesthetically acceptable scrotum with minimal donor site morbidity. Case presentation We described the case of a 60-year-old man with a large scrotal loss from Fournier’s gangrene following bladder outlet obstruction and perineal abscess. He had multiple debridement and reconstruction with pedicled left gracilis muscle flap with a good aesthetic and functional post-operative outcome. The major challenge encountered was the loss of the skin graft as a result of the retraction of the muscle flap due to too early ambulation; this can thus be avoided by adequate pre-operative counseling and enforcing bed rest. Conclusions The use of gracilis muscle flap in the reconstruction of large scrotal defect described in this report has the additional advantage of creating a pliable and soft feel like that of the original scrotum with minimal donor site morbidity.

scholarly journals A CASE OF FOURNIER'S GANGRENE RECONSTRUCTED USING A RECTUS ABDOMINIS MUSCLE FLAP

2011 ◽  
Vol 102 (4) ◽  
pp. 649-654 ◽  
Author(s):  
Masato Yanagi ◽  
Taiji Nishimura ◽  
Yukihiro Kondo ◽  
Keiichi Yamazaki ◽  
Shigeki Sakai ◽  
...  
Keyword(s):  
Muscle Flap ◽  
Fournier’S Gangrene ◽  
Rectus Abdominis ◽  
Rectus Abdominis Muscle ◽  
Fournier's Gangrene ◽  
Rectus Abdominis Muscle Flap

Donor-Site Morbidity of Free Muscle and Perforator Flaps: Comparison of the Gracilis Muscle Flap and the Anterolateral Thigh Flap

2017 ◽  
Vol 33 (07) ◽  
pp. 526-532 ◽  
Author(s):  
M. Rassner ◽  
J. Kiefer ◽  
H. Bannasch ◽  
G. Stark ◽  
S. Eisenhardt ◽  
...  
Keyword(s):  
Lower Extremity ◽  
Donor Site ◽  
Muscle Flap ◽  
Donor Site Morbidity ◽  
Gracilis Muscle ◽  
Perforator Flaps ◽  
Muscle Flaps ◽  
Gracilis Muscle Flap ◽  
Anterolateral Thigh ◽  
Alt Flap

Background Both the gracilis muscle flap and the anterolateral thigh (ALT) flap have been described as successful reconstructive options for defect coverage after trauma or tumor resection. In general, free perforator flaps are considered to generate less donor-site morbidity than muscle flaps. Here, we put this hypothesis to the test. Methods In this study, 193 patients who had undergone free flap reconstruction with either free gracilis muscle flaps (n = 131) or ALT flaps (n = 62) were included. Subjective patient satisfaction with the aesthetic and functional outcome of the donor sites was assessed using a self-report questionnaire as well as the Lower Extremity Functional Scale (LEFS). Results Comparing the donor-site morbidity of free ALT and gracilis flaps, the LEFS revealed no significant differences in functional impairment (p = 0.6447) of the lower extremity. The donor-site scar was significantly longer after ALT flap harvest (mean: 21.16 cm) than after gracilis muscle flap harvest (mean: 14.17 cm; p < 0.0001). Furthermore, donor-site numbness was significantly greater in the ALT group than in the gracilis group (p = 0.0068). Conclusion No significant differences in functional impairment of the lower extremity were reported after gracilis muscle and ALT flap harvest. Regarding scar length and level of numbness of the donor site, the gracilis muscle flap was shown to be superior to the ALT flap.

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