Fournier's gangrene - delayed pedicle flap based upon the anterior abdominal wall

Ania Sliwinski, Liam E Kavanagh, Damien Michael Bolton, Nathan Lawrentschuk, John Gerard Crock

Research output: Contribution to journalArticleOther

Abstract

Introduction: Fournier s gangrene is a poly-microbial necrotizing fasciitis that involves the perineum and/or external genitalia. Urgent surgical debridement is well recognized as essential acute treatment yet unique challenges arise for plastic surgical reconstruction to obtain a complete functional recovery. This case describes a successful delayed pedicle flap repair based upon the anterior abdominal wall. Case description: A 24 year old man was admitted to ICU ten days after elective circumcision with Fournier s gangrene. He underwent a number of surgical debridements, and was referred for plastic surgical management. He had penile reconstruction using a random pattern abdominal flap, which was performed as a three stage procedure including flap vascular delay technique. Discussion: Perineal and penile skin loss can be significant and is difficult to repair. Various techniques have been used to reconstruct lost tissue: skin grafts, transposition of the testes and spermatic cords to the thigh, flaps, and other types of pediculated myocutaneous flaps. Muscle flap reconstruction provides an environment that allows for complete regeneration of the urethral epithelium but is bulky and unsightly. Skin grafts contract and may produce painful and dysfunctional reconstructions. This novel technique produces a functional, and aesthetic reconstruction. Conclusion: Penile skin recovery following Fournier s gangrene recovery is problematic. This case demonstrates the functionality of a delayed flap repair using the anterior abdominal wall.
Original languageEnglish
Pages (from-to)423 - 426
Number of pages4
JournalInternational Brazilian Journal of Urology
Volume40
Issue number3
DOIs
Publication statusPublished - 2014

Cite this

Sliwinski, Ania ; Kavanagh, Liam E ; Bolton, Damien Michael ; Lawrentschuk, Nathan ; Crock, John Gerard. / Fournier's gangrene - delayed pedicle flap based upon the anterior abdominal wall. In: International Brazilian Journal of Urology. 2014 ; Vol. 40, No. 3. pp. 423 - 426.
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abstract = "Introduction: Fournier s gangrene is a poly-microbial necrotizing fasciitis that involves the perineum and/or external genitalia. Urgent surgical debridement is well recognized as essential acute treatment yet unique challenges arise for plastic surgical reconstruction to obtain a complete functional recovery. This case describes a successful delayed pedicle flap repair based upon the anterior abdominal wall. Case description: A 24 year old man was admitted to ICU ten days after elective circumcision with Fournier s gangrene. He underwent a number of surgical debridements, and was referred for plastic surgical management. He had penile reconstruction using a random pattern abdominal flap, which was performed as a three stage procedure including flap vascular delay technique. Discussion: Perineal and penile skin loss can be significant and is difficult to repair. Various techniques have been used to reconstruct lost tissue: skin grafts, transposition of the testes and spermatic cords to the thigh, flaps, and other types of pediculated myocutaneous flaps. Muscle flap reconstruction provides an environment that allows for complete regeneration of the urethral epithelium but is bulky and unsightly. Skin grafts contract and may produce painful and dysfunctional reconstructions. This novel technique produces a functional, and aesthetic reconstruction. Conclusion: Penile skin recovery following Fournier s gangrene recovery is problematic. This case demonstrates the functionality of a delayed flap repair using the anterior abdominal wall.",
author = "Ania Sliwinski and Kavanagh, {Liam E} and Bolton, {Damien Michael} and Nathan Lawrentschuk and Crock, {John Gerard}",
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Fournier's gangrene - delayed pedicle flap based upon the anterior abdominal wall. / Sliwinski, Ania; Kavanagh, Liam E; Bolton, Damien Michael; Lawrentschuk, Nathan; Crock, John Gerard.

In: International Brazilian Journal of Urology, Vol. 40, No. 3, 2014, p. 423 - 426.

Research output: Contribution to journalArticleOther

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AU - Kavanagh, Liam E

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AU - Lawrentschuk, Nathan

AU - Crock, John Gerard

PY - 2014

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AB - Introduction: Fournier s gangrene is a poly-microbial necrotizing fasciitis that involves the perineum and/or external genitalia. Urgent surgical debridement is well recognized as essential acute treatment yet unique challenges arise for plastic surgical reconstruction to obtain a complete functional recovery. This case describes a successful delayed pedicle flap repair based upon the anterior abdominal wall. Case description: A 24 year old man was admitted to ICU ten days after elective circumcision with Fournier s gangrene. He underwent a number of surgical debridements, and was referred for plastic surgical management. He had penile reconstruction using a random pattern abdominal flap, which was performed as a three stage procedure including flap vascular delay technique. Discussion: Perineal and penile skin loss can be significant and is difficult to repair. Various techniques have been used to reconstruct lost tissue: skin grafts, transposition of the testes and spermatic cords to the thigh, flaps, and other types of pediculated myocutaneous flaps. Muscle flap reconstruction provides an environment that allows for complete regeneration of the urethral epithelium but is bulky and unsightly. Skin grafts contract and may produce painful and dysfunctional reconstructions. This novel technique produces a functional, and aesthetic reconstruction. Conclusion: Penile skin recovery following Fournier s gangrene recovery is problematic. This case demonstrates the functionality of a delayed flap repair using the anterior abdominal wall.

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