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Synchronous penile urethra onlay patch and scrotal reconstruction after Fournier's gangrene using medial thigh flaps

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Abstract

Massive penoscrotal skin loss, frequently a sequela of Fournier's gangrene, can sometimes be successfully treated using skin grafts alone. If the urological debridement has been extensive with a concomitant disruption of the urethra, a regional vascularized flap must be introduced. A superiorly based fasciocutaneous flap can be constructed on the medial thigh to provide scrotal reconstruction. The underlying gracilis muscle is an ideal onlay patch for ventral penile defects. Simultaneous use of independent, multiple flaps from a single medial thigh donor site allows coverage of separate penile and scrotal deformities, and leaves only a linear scar.

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References

  1. Horton CE, Jordan GH, Spindel MR (1990) Reconstruction of male genital defects: acquired. In: McCarthy JG (ed) Plastic surgery. Saunders, Philadelphia, pp 4194–4199

    Google Scholar 

  2. Horton CE, Devine CJ, Graham JK (1980) Fistulas of the penile urethra. Plast Reconstr Surg 66:407

    Google Scholar 

  3. Schaller P, Akcetin Z, Kuhn R, Radu C, Geldmacher J (1994) Scrotal reconstruction after Fournier's gangrene with simple skin grafting. Eur J Plast Surg 17:261

    Google Scholar 

  4. Netscher DT, Marchi M, Wigoda P (1993) A method for optimizing skin graft healing and outcome of wounds of the penile shaft and scrotum. Ann Plast Surg 31:447

    Google Scholar 

  5. Horton CE, Kaplan I (1990) Local skin flaps of the penis. In: Strauch B, Vasconez LO, Hall-Findlay EJ (ed) Grabb's encyclopedia of flaps, vol III. Little, Brown, Boston, pp 1465–1476

    Google Scholar 

  6. Heckler FR, Aldridge JE, Songcharoen S, Jabaley ME (1980) Muscle flaps and musculocutaneous flaps in the repair of urinary fistulas. Plast Reconstr Surg 66:94

    Google Scholar 

  7. Osman OF (1994) Extended use of scrotal septal island skin flap for the repair of penile hypospadias. Ann Plast Surg 33:525

    Google Scholar 

  8. Sakai S, Soeda S, Yoshii S (1990) Scrotal septocutaneous island flap for the reconstruction of the urethral fistula. Ann Plast Surg 24:49

    Google Scholar 

  9. Kenney JG, Fairbanks DW, Berman DE (1990) The Dartos musculocutaneous island flap in urethral reconstruction. Ann Plast Surg 24:63

    Google Scholar 

  10. Hallock GG (1990) Scrotal reconstruction following Fournier's gangrene using the medial thigh fasciocutaneous flap. Ann Plast Surg 24:86

    Google Scholar 

  11. Heckler FR (1980) Gracilis myocutaneous and muscle flaps. Clin Plast Surg 7:27

    Google Scholar 

  12. Wang N, Whetzel T, Mathes SJ, Vasconez LO (1987) A fasciocutaneous flap for vaginal and perineal reconstruction. Plast Reconstr Surg 80:95

    Google Scholar 

  13. Ustuner TE, Mutaf M, Sensoz O (1994) Anteromedial thigh: a source for phallic reconstruction. Ann Plast Surg 32:426

    Google Scholar 

  14. Hallock GG (1992) The Chimera flap principle: conjoint flaps. In: Hallock GG (ed) Fasciocutaneous flaps, Blackwell, Boston, pp 172–180

    Google Scholar 

  15. Cormack GC, Lamberty BGH (1985) The blood supply of thigh skin. Plast Reconstr Surg 75:342

    Google Scholar 

  16. Ponten B (1981) The fasciocutaneous flap: its use in soft tissue defects of the lower leg. Br J Plast Surg 34:215

    CAS  PubMed  Google Scholar 

  17. Devine PC, Wendelken JR, Devine CJ (1979) Free full thickness skin graft urethroplasty: current technique. J Urol 121: 282

    Google Scholar 

  18. Lai CS, Chou CK, Yang CC, Lin SD (1990) Immediate reconstruction of the penis with an iliac flap. Br J Plast Surg 43:621

    Google Scholar 

  19. Gilbert DA, Horton CE, Terzis JK, Devine CJ, Winslow BH, Devine PC (1987) New concepts in phallic reconstruction. Ann Plast Surg 18:128

    Google Scholar 

  20. Kamei Y, Aoyama H, Yokoo K, Fujii K, Kondo C, Sato T, Onishi S (1994) Composite gastric seromuscular and omental pedicle flap for urethral and scrotal reconstruction after Fournier's gangrene. Ann Plast Surg 33:565

    Google Scholar 

  21. Hirshowitz B, Moscona R, Kaufman T, Pnini A (1980) One-stage reconstruction of the scrotum following Fournier's syndrome using a probable arterial flap. Plast Reconstr Surg 66:608

    Google Scholar 

  22. Hirshowitz B, Peretz BA (1982) Bilateral superomedial thigh flaps for primary reconstruction of scrotum and vulva. Ann Plast Surg 8:390

    Google Scholar 

  23. Young WA, Wright JK (1988) Scrotal reconstruction with a rectus abdominis muscle flap. Br J Plast Surg 41:190

    Google Scholar 

  24. Westfall CT, Keller HB (1981) Scrotal reconstruction utilizing bilateral gracilis myocutaneous flaps. Plast Reconstr Surg 68:945

    Google Scholar 

  25. Orticochea M (1972) A new method of total reconstruction of the penis. Br J Plast Surg 25:347

    Google Scholar 

  26. Hage JJ, de Graaf FH, van den Hoek J, Bloem JJAM (1993) Phallic construction in female-to-male transsexuals using a lateral upper arm sensate free flap and a bladder mucosa graft. Ann Plast Surg 31:275

    Google Scholar 

  27. Furnas DW, McCraw JB (1980) Resurfacing the genital area. Clin Plast Surg 7:235

    Google Scholar 

  28. Sadove RC, Sengezer M, McRoberts JW, Wells MD (1993) One-stage total penile reconstruction with a free sensate osteocutaneous fibula flap. Plast Reconstr Surg 92:1314

    Google Scholar 

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Authors and Affiliations

  1. Division of Plastic Surgery, The Lehigh Valley Hospital, Allentown, Pennsylvania, USA

    G. G. Hallock

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  1. G. G. Hallock
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Hallock, G.G. Synchronous penile urethra onlay patch and scrotal reconstruction after Fournier's gangrene using medial thigh flaps. Eur J Plast Surg 19, 105–106 (1996). https://doi.org/10.1007/BF00207927

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  • DOI: https://doi.org/10.1007/BF00207927

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