Total scrotal reconstruction following Fournier's gangrene with bilateral prelaminated superior medial thigh flaps

BMJ Case Rep. 2021 Apr 15;14(4):e240618. doi: 10.1136/bcr-2020-240618.


The patient is a 45-year-old man diagnosed with Fournier's gangrene and underwent treatment for septic shock, broad-spectrum antibiotic therapy and extensive surgical debridement of perineum, including total scrotectomy, ischiorectal fossa, abdomen and left superior thigh and flank. The patient required multiple staged complex reconstruction of the scrotum utilising prelaminated superior medial thigh flaps with use of dermal matrix, split-thickness skin grafting and pedicled gracilis muscle flap for coverage of the ischiorectal wound. The patient had full recovery and followed up 1 year postoperatively. This report discusses our technique for total scrotal reconstruction and provides review of surgical reconstructive techniques for wounds due to Fournier's gangrene.

Keywords: general surgery; infections; plastic and reconstructive surgery; skin.

Publication types

  • Case Reports

MeSH terms

  • Debridement
  • Fournier Gangrene* / surgery
  • Humans
  • Male
  • Middle Aged
  • Plastic Surgery Procedures*
  • Scrotum / surgery
  • Surgical Flaps
  • Thigh / surgery