Coskunfirat O Koray, Uslu Asim, Cinpolat Ani, Bektas Gamze
Department of Plastic and Reconstructive Surgery, Akdeniz University School of Medicine, Antalya, Turkey.
Ann Plast Surg. 2011 Nov;67(5):526-30. doi: 10.1097/SAP.0b013e318208ff00.
Scrotal skin has unique cosmetic and functional features that make its reconstruction difficult. Coverage of the testicles and constituting a good cosmetic appearance are major expectations from a successful reconstruction. Usually flaps are the choice for scrotal reconstruction, but every single flap has its own characteristics. In our series, between January 2006 and January 2010, the medial circumflex femoral artery perforator flap was used in 7 male patients for scrotal coverage after Fournier gangrene. Six flaps were raised based on a single perforator from the gracilis muscle; however in one flap 2 perforators were used. Flaps were carried to the defect either by transposition or by V-Y advancement. Donor areas were closed directly in all patients, and stable scrotal coverage was achieved with an acceptable scrotal contour and cosmesis. No major complication was seen due the perforator flap surgery, in 2 patients wound dehiscence were noted and they healed by secondary intention or by secondary suturing. For scrotal reconstruction, the medial circumflex femoral artery perforator flap is a good option with its good mobility, thinness for scrotal contour, possibility for muscle preservation, and direct closure of the donor site. All these advantages can be accomplished in 1 procedure.
阴囊皮肤具有独特的外观和功能特点，这使得其重建颇具难度。成功重建的主要期望是覆盖睾丸并呈现良好的外观。通常皮瓣是阴囊重建的选择，但每种皮瓣都有其自身特点。在我们的系列研究中，2006年1月至2010年1月期间，7例男性患者在发生福尼尔坏疽后采用旋股内侧动脉穿支皮瓣覆盖阴囊。6个皮瓣基于来自股薄肌的单一穿支掀起；然而有1个皮瓣使用了2个穿支。皮瓣通过转移或V-Y推进的方式转移至缺损处。所有患者的供区均直接缝合，获得了稳定的阴囊覆盖，阴囊外形和美观度可接受。穿支皮瓣手术未出现重大并发症，2例患者出现伤口裂开，经二期愈合或二期缝合后愈合。对于阴囊重建，旋股内侧动脉穿支皮瓣是一个不错的选择，它具有良好的可移动性、适合阴囊外形的薄度、保留肌肉的可能性以及供区直接缝合等优点。所有这些优点都可以在一次手术中实现。
