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Total scrotal reconstruction following Fournier’s gangrene with bilateral prelaminated superior medial thigh flaps
  1. Justin Hart,
  2. Jeffrey DeSano,
  3. Raymond Hajjar and
  4. Christopher Lumley
  1. Plastic Surgery, Beaumont Hospital - Farmington Hills, Farmington Hills, Michigan, USA
  1. Correspondence to Dr Justin Hart; justin.hart{at}


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.

  • plastic and reconstructive surgery
  • general surgery
  • infections
  • skin

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  • Contributors Patient was under the care of CL and RH. Report written by JH, JD, CL and RH.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Provenance and peer review Not commissioned; externally peer-reviewed.

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