Medial Femoral Circumflex Artery Perforator Based Fasciocutaneous Flap Aided in Healing of Scrotal Defect due to Fournier Gangrene

Seok Won Hong; Hwan Jun Choi; Jun Hyuk Kim

doi:10.12790/ahm.2019.24.3.254

Journal List > Arch Hand Microsurg > v.24(3) > 1143549

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Hong, Choi, and Kim: Medial Femoral Circumflex Artery Perforator Based Fasciocutaneous Flap Aided in Healing of Scrotal Defect due to Fournier Gangrene

Case Report

Arch Hand Microsurg 2019;24(3):254-259.

Published online: 5 January 2019

DOI: https://doi.org/10.12790/ahm.2019.24.3.254

Medial Femoral Circumflex Artery Perforator Based Fasciocutaneous Flap Aided in Healing of Scrotal Defect due to Fournier Gangrene

Seok Won Hong¹, Hwan Jun Choi^1,², Jun Hyuk Kim¹

¹Department of Plastic and Reconstructive Surgery, Soonchunhyang University College of Medicine, Cheonan, Korea

²Institute of Tissue Regeneration, Soonchunhyang University, Cheonan, Korea

Corresponding author: Hwan Jun Choi Department of Plastic and Reconstructive Surgery, Soonchunhyang University Cheonan Hospital, 31 Sooncheonhyang 6-gil, Dongnam-gu, Cheonan 31151, Korea TEL: +82-41-570-2195, FAX: +82-41-574-6133, E-mail: medi619@hanmail.net, ORCID: https://orcid.org/0000-0002-0752-0389

Received 7 February 201920 July 2019 Accepted 12 August 2019

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

초록

Fournier's gangrene is a rare, highly infectious necrotizing fasciitis of the perineum and genital area which is caused by a mixture of various bacterial organism. Treatment is predominantly surgical, including extensive and early drainage and debridement, considering negative-pressure wound therapy for helping to heal the wounds and broad-spectrum intrave-nous antibiotics therapy. Some reports have described the use of negative-pressure wound therapy combined with split thickness skin graft in the defect area. While, other recent reports suggest that local flap coverage rather than skin graft for reconstruction of perineal area. This study aims to suggest the use of medial femoral circumflex artery perforator based thigh flap for scrotal and perineal reconstruction in open areas secondary to the surgical debridement and negative-pressure wound therapy of Fournier's gangrene.

Keywords: Necrotizing fasciitis, Perforator flap, Fournier gangrene, Perineum

REFERENCES

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Fig. 1.

A 48-year-old male with scrotal and perineal defects due to Fournier's gangrene. (A) Post-opertive periods: 21 days of debridement and negative-pressure wound therapy (B) right unilateral testis totally was exposed.

Fig. 2.

A 48-year-old male with scrotal and perineal defects due to Fournier's gangrene. Using handheld Doppler, we marked the blue circle meaning the perforator of medial femoral circumflex artery and designed V-Y pattern fascio-cutaneos flap for reconstruction.

Fig. 3.

Under microscope, the perforator of medical femoral circumflex artery to skin flap which runs deep between the adductor magnus and longus was found and preserved.

Fig. 4.

Dissected and mobilized flap. Medical femoral circumflex artery perforator preserved V-Y pattern fasciocutaneous flap was elevated without direct muscle handling.

Fig. 5.

Postoperative images after 12 days. There was no complication within adequate functional and aesthetic results.

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