Hart Justin, DeSano Jeffrey, Hajjar Raymond, Lumley Christopher
Plastic Surgery, Beaumont Hospital - Farmington Hills, Farmington Hills, Michigan, USA
Plastic Surgery, Beaumont Hospital - Farmington Hills, Farmington Hills, Michigan, USA.
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.
该患者为一名45岁男性，被诊断为福尼尔坏疽，并接受了感染性休克治疗、广谱抗生素治疗以及会阴广泛手术清创，包括全阴囊切除术、坐骨直肠窝、腹部、左上大腿和侧腹清创。患者需要使用预构的大腿内侧上份皮瓣，联合使用真皮基质、中厚皮片移植和带蒂股薄肌皮瓣，对阴囊进行多阶段复杂重建，以覆盖坐骨直肠窝伤口。患者完全康复，并在术后1年进行了随访。本报告讨论了我们全阴囊重建的技术，并对福尼尔坏疽所致伤口的手术重建技术进行了综述。
