Dent Briar L, Dinesh Anant, Khan Khuram, Engdahl Ryan
Department of Surgery, Division of Plastic Surgery, New York-Presbyterian Hospital/Weill Cornell Medicine, New York, USA.
Department of Surgery, Harlem Hospital Center, Columbia University, New York, USA.
J Emerg Trauma Shock. 2018 Jan-Mar;11(1):57-59. doi: 10.4103/JETS.JETS_62_17.
Scrotal loss from Fournier's gangrene can be a devastating injury with esthetic and functional consequences. Local reconstructive options can be limited by the presence of infection or the loss of neighboring tissue from debridement. Integra bilayer matrix wound dressing is a well-established reconstructive modality, but only one report exists of its use in scrotal reconstruction and this was not in the setting of Fournier's gangrene. We report the successful use of Integra and a subsequent split-thickness skin graft for reconstruction of the anterior scrotum and coverage of the exposed testes in a 43-year-old man who developed Group A Streptococcus necrotizing fasciitis of his right lower extremity, groin, and scrotum requiring serial operative debridements. Stable testicular coverage was achieved with closely matched skin and minimal donor-site morbidity. Further study and a larger sample size will be necessary to better understand the advantages and disadvantages of scrotal reconstruction with Integra.
福尼尔坏疽导致的阴囊缺失可能是一种具有美学和功能后果的毁灭性损伤。局部重建方案可能会受到感染的存在或清创导致的邻近组织缺失的限制。Integra双层基质伤口敷料是一种成熟的重建方式，但仅有一篇关于其用于阴囊重建的报道，且并非在福尼尔坏疽的情况下。我们报告了一名43岁男性成功使用Integra并随后进行中厚皮片移植来重建阴囊前部并覆盖暴露睾丸的病例，该患者患有右下肢、腹股沟和阴囊的A组链球菌坏死性筋膜炎，需要多次手术清创。通过紧密匹配的皮肤实现了稳定的睾丸覆盖，且供区发病率极低。需要进一步研究和更大的样本量，以更好地了解使用Integra进行阴囊重建的优缺点。
