Editorial Comment

Abstract

Fournier's gangrene had historic mortality rates that ranged from 20–88%. However, in contemporary population-based studies, its mortality is substantially less likely(only 7.5%) because of the advent of better surgical and intensive care unit care, especially at tertiary hospitals. 1 Sorensen M.D. Krieger J.N. Rivara F.P. et al. Fournier's gangrene: management and mortality predictors in a population based study. J Urol. 2009; 182: 2742-2747 Abstract Full Text Full Text PDF Scopus (79) Google Scholar , 2 Sorensen M.D. Krieger J.N. Rivara F.P. et al. Fournier's gangrene: population based epidemiology and outcomes. J Urol. 2009; 181: 2120-2126 Abstract Full Text Full Text PDF PubMed Scopus (165) Google Scholar Attention to the best methods of genital reconstruction after Fournier's gangrene is important because most patients now survive the acute infection. Extensive debridement in the treatment of Fournier's gangrene leads to large tissue defects that are closed with local flaps or treated with extensive skin grafts. Management of the testes, which usually are salvageable, is variable and the options after the scrotum has been removed include orchiectomy, placement of the testes in subcutaneous thigh pouches, skin grafts, or local flaps for reconstruction of a neoscrotum. Penoscrotal Reconstruction With Gracilis Muscle Flap and Internal Pudendal Artery Perforator Flap TranspositionUrologyVol. 79Issue 6PreviewExtensive defects of the perineal area, with exposure of the testes, are difficult to reconstruct. For the reconstruction of these defects, we applied gracilis muscle flap combined with pudendal artery perforator fasciocutaneous flap, which provided us a reliable cutaneous flap and allowed us to cover exposed testes with sufficient muscular volume. Full-Text PDF ReplyUrologyVol. 79Issue 6PreviewFournier's gangrene is a disease that occurs and progresses suddenly with a high mortality risk. If the disease is not treated and controlled in the early stage, it could prove fatal to the patients by failure of multiple organs and infection spreading. Therefore, aggressive treatment should be done in the acute phase to improve the overall survival rate, which includes administration of broad-spectrum antibiotics and prompt but extensive debridement with conservative wound management.1 Reconstruction would not be considered as an option in this phase. Full-Text PDF