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Reconstruction after Fourniers Gangrene: A Surgeon’s Experience

Chetan Satish, Associate Professor, Department of General Surgery, Sapthagiri Medical College, Bangalore, Karnataka 560090, India. , Chetan Satish

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New Indian Journal of Surgery 9(6):p 721-724, Nov-Dec 2018. | DOI: DOI: https://dx.doi.org/10.21088/nijs.0976.4747.9618.5

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Abstract

  Background: Fournier gangrene often results in defects involving lower abdominal wall, perineum, scrotum with exposed testes. The coverage of these defects often is a challenge for the reconstructive surgeon. Reconstruction with coverage of exposed testes with skin grafts or flaps have been described with specific protocol. Methods: The study was done on consequent 17 male patients who presented with fourniers gangrene from jan 2015 to jan 2017. Minimum follow up was 1year. 4 patients were treated with scrotal advancement and closure, 3 patients were treated with testes deposition in medial thighs and closure and 8 patients were treated with skin grafts. 2 of our patients required pudendal flaps. Results: All patients healed well with no recurrence at 1 year follow up period. 2 patients with skin graft had partial graft loss which healed conservatively. Conclusion: Our results show that proper selection of method of treatment for fourniers gangrene can give very good results in this debilitating condition with minimal recurrence. We have elaborated on the choice of surgical method while treating fourniers gangrene and tried to simplify the treatment of fourniers gangrene for the help of surgeons. Flap coverage over skin grafts has not proven to have much proven benefit. We recommend reconstruction with skin grafts or flap reconstruction for defects involving greater than 50 percent of scrotum where as simpler   techniques such as secondary intention healing or scrotal advancement is recommended for defects involving less than 50 percent of scrotum. 

Keywords: Fourniers Gangrene; Skin Graft; Scrotal Advancement.  

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DOI: DOI: https://dx.doi.org/10.21088/nijs.0976.4747.9618.5

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