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Anteriorly based pudendal thigh flap for scrotal reconstruction based on the deep external pudendal artery (DEPA) flap

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European Journal of Plastic Surgery Aims and scope Submit manuscript

Abstract

Background

Major scrotal skin loss represents a significant challenge for reconstructive surgeons. Although many therapeutic methods have been established for the treatment of such defects, each technique has its own advantages and disadvantages. A posteriorly based pudendal thigh fasciocutaneous flap at the perianal region has been described for reconstruction of genital organs, but an anteriorly based pudendal thigh fasciocutaneous flap has not been described for scrotal reconstruction.

Aim

The aim of this study was to introduce and evaluate the use of an anteriorly based pudendal thigh flap for scrotal reconstruction.

Methods

Twenty flaps in 15 patients with major scrotal defects were subjected to reconstruction using this flap. The etiology of scrotal loss was Fournier gangrene in all cases. Five patients each underwent bilateral and ten patient unilateral reconstructions, by the anteriorly based pudendal thigh flap, based on the deep external pudendal artery (DEPA).

Results

All 20 flaps survived completely. Additionally, the donor site was closed directly, and the scar was hidden in the perineal crease. The donor site healed uneventfully, as one patient required a secondary procedure for healing.

Conclusion

An anteriorly based pudendal thigh flap is highly reliable for coverage of major scrotal defects. This flap allows adequate coverage with excellent aesthetic appearance of the scrotum.

Level of Evidence: Level II, therapeutic study.

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Acknowledgments

The author thanks the Department of Plastic and Reconstructive Surgery of Al-Hussain University Hospital. The authors also thanks Dr. Yahya Emara, resident physician of the Department of Plastic Surgery, for providing a schematic representation.

Author information

Authors and Affiliations

  1. Plastic Surgery Department, Al-Hussein University Hospital, Cairo, Egypt

    Magdy Ahmed Abd-Al Moktader

  2. Faculty of Medicine, Al-Azhar University, Cairo, Egypt

    Magdy Ahmed Abd-Al Moktader

Authors
  1. Magdy Ahmed Abd-Al Moktader
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Correspondence to Magdy Ahmed Abd-Al Moktader.

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Conflict of interest

Magdy Ahmed Abd-Al Moktader declares that he has no conflict of interest.

Ethical standards

The procedures performed in this study were in accordance with the ethical standards of the institutional research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

Funding

The creation of this article was not supported by any outside funds.

Patient consent

Informed consent was obtained from all individual participants included in the study.

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Abd-Al Moktader, M.A. Anteriorly based pudendal thigh flap for scrotal reconstruction based on the deep external pudendal artery (DEPA) flap. Eur J Plast Surg 39, 107–112 (2016). https://doi.org/10.1007/s00238-015-1160-8

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  • DOI: https://doi.org/10.1007/s00238-015-1160-8

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