Abstract

ABSTRACT:
BACKGROUND:
Skin loss of perinioscrotal region may result from severe infections, avulsion trauma or crush wounds. Replacement with sensible durable cover is mandatory for functional, cosmetic and psychological reasons. Wide range of flap techniques have been reported for these purposes.
OBJECTIVE:
To evaluate the use of superomedial fasciocutaneous thigh flap for replacement of scrotal and penile skin loss.
PATIENTS AND METHOD:
7 male patients aged between 25 and 69 years(mean=53.4) were included in this study. All of them presented, in the period between2007-2010,with scrotal and penile skin loss. Four of them were with Fournier's gangrene, one was with history of agriculture accident, one with crush wound, and the last one was with penile skin loss after improper use of penile clamp. Superomedial fasciocutaneous thigh flaps were planned, elevated at subfascial plane, then transferred to close the wounds. Bilateral flaps were used in five patients for total scrotal reconstruction. All patients were followed for 3-13 months.
RESULTS:
12 flaps were used for the 7 patients with complete survival. These provided nice durable covers of the testes with good sensation. The flaps were moderately bulky in one patient. Other complications included serous fluid collection in one patient, wound dehiscence in two patients, paresthesia of the anterior aspect of thigh in 2 patient, and mild leg edema in one patient. All complications were transient and responded well to conservative treatment.
CONCLUSION:
Superomedial fasciocutaneous thigh flap is a good choice for scrotal and penile reconstruction that could provide a sensible, durable cover that fulfills patient satisfaction.