Puranik Ashok, Baskaran Suruthi, Kumar Ravi R
General Surgery, All India Institute of Medical Sciences, Jodhpur, Jodhpur, IND.
Cureus. 2022 Aug 1;14(8):e27581. doi: 10.7759/cureus.27581. eCollection 2022 Aug.
Fournier's gangrene, which is a necrotizing fasciitis of the perineal region, requires prompt control of infection with emergent surgical debridement. The shameful exposure of gonads, which occurs following debridement, can cause both physiological and psychological impairment to the patient. These can be avoided by the use of this novel technique for testicular preservation. Following debridement of necrotic scrotal skin, this technique involves creation of inguinal pouch by blunt dissection and placement of the testes in the pouch created. Once healthy granulation tissue is achieved in the scrotal wound, closure of the scrotum is performed after bringing down the testes. The advantages of this technique include development of a relatively physiological position to preserve the testes before definitive reconstruction of the scrotum and the easy reproducibility of the technique. A holistic approach to management of Fournier's gangrene should include resuscitation, administration of antibiotics, debridement, and scrotal reconstruction. However, the psychological impact of shameful exposure of the gonads must also be borne in mind during the management. Our technique represents one of the ways to reduce the stigma and discomfort associated with shameful exposure of the testes.
福尼尔坏疽是一种会阴部坏死性筋膜炎，需要通过紧急手术清创来迅速控制感染。清创后出现的性腺暴露会给患者造成生理和心理上的损害。而使用这种新型睾丸保留技术可以避免这些情况。在对坏死的阴囊皮肤进行清创后，该技术包括通过钝性分离创建腹股沟袋，并将睾丸放置在创建好的袋中。一旦阴囊伤口形成健康的肉芽组织，在将睾丸复位后进行阴囊闭合。该技术的优点包括在阴囊进行最终重建之前，能将睾丸置于相对符合生理的位置进行保留，且该技术易于重复操作。福尼尔坏疽的整体治疗方法应包括复苏、使用抗生素、清创和阴囊重建。然而，在治疗过程中也必须考虑到性腺暴露带来的心理影响。我们的技术是减少与睾丸暴露相关的耻辱感和不适感的方法之一。
