Yamakawa Sho, Hayashida Kenji
Division of Plastic and Reconstructive Surgery, Faculty of Medicine, Shimane University, Shimane, Japan.
J Plast Reconstr Surg. 2022 Jan 27;1(1):26-30. doi: 10.53045/jprs.2021-0011.
Scrotal defects requiring reconstruction may occur after trauma, cancer, or infection. To maintain good testicular function, the ideal scrotal temperature should be slightly lower than the abdominal temperature. However, large local flaps that are enough to cover the testes cannot be used in all patients. A 74-year-old man presented with scrotal and perineal tissue defects after undergoing debridement for Fournier's gangrene due to rectal carcinoma-induced perforation. The scrotal skin defect was reconstructed using a 22 × 10-cm-free ulnar forearm flap. The postoperative course was uneventful, and at the 14-month follow-up examination, the scrotal skin was found to be thin and pliable. Moreover, the donor site on the left forearm was in an acceptable state and no hand dysfunction due to contracture was observed. Based on our observations, we recommend that the free ulnar forearm flap might be an effective option for scrotal reconstruction, causing little donor site morbidity.
需要重建的阴囊缺损可能发生在创伤、癌症或感染之后。为维持良好的睾丸功能,理想的阴囊温度应略低于腹部温度。然而,并非所有患者都能使用足够覆盖睾丸的大型局部皮瓣。一名74岁男性因直肠癌穿孔导致福尼尔坏疽,在接受清创术后出现阴囊与会阴组织缺损。采用一块22×10厘米的游离尺侧前臂皮瓣重建阴囊皮肤缺损。术后过程顺利,在14个月的随访检查中,发现阴囊皮肤薄且柔软。此外,左前臂供区状态尚可,未观察到因挛缩导致的手部功能障碍。基于我们的观察,我们建议游离尺侧前臂皮瓣可能是阴囊重建的有效选择,供区并发症少。