[Uni- and bilateral pedicled muscular gracilis flaps for reconstruction of the scrotum in Fournier's gangrene]

Abstract

Fournier's gangrene is still a major cause for the development of soft tissue defects of the perineum and is associated with a mortality of 40-67% of all patients. Along with the initial life-preserving treatment such as broad-spectrum antibiotics and multifold agressive surgical debridement, reconstruction of the body contour is of the utmost importance for these patients. An individual adjustment of treatment in every single case is required due to the wide variety of the resulting complex soft tissue defects and differing patient profiles. Most publications describe the use of musculo- or fasciocutaneous flaps for scrotal reconstruction. In this paper, we present two cases of successfully performed plastic reconstructions of the scrotum using a solely muscular gracilis flap to cover the exposed testicles, followed by a split-skin graft to cover the muscle. The plasticity of the muscle and the variability of flap design resulted along with the transplanted mesh-graft in an excellent outcome for the patient with respect to function, form and quality of life.