Intérêt du lambeau fasciocutané médial de la cuisse dans la gangrène de Fournier

Abstract

IntroductionThe authors propose a focus on the management of perineoscrotal defects caused by Fournier's gangrene, and emphasize the importance of the medial thigh fasciocutaneous flap. Patients and methodsThis a retrospective study of 12 cases of Fournier's gangrene managed initially by intensivists and urologists then addressed to plastic surgeons for skin coverage. The latter was achieved through a medial thigh fasciocutaneous flap, unilateral in some cases, bilateral in others. ResultsAll patients were male, 63 years on average, and the defect was perineoscrotal, associated in three cases with penile skin defect. The medial thigh fasciocutaneous flap was bilateral in 8 cases. We deplore two cases of partial necrosis. Long-term cosmetic results were satisfactory. Conclusioncoverage of perineoscrotal defect in Fournier's gangrene was dominated for a long time by burying the testicles and skin grafting. Certainly these two techniques are simple, but they are not always achievable. Compared to other flaps, musculocutaneous in this case, the medial thigh fasciocutaneous flap remains simple, useful, and is associated with lower morbidity. It must occupy a prominent place in the cover of such defects, especially in the elderly, in whom the desire for procreation is no longer a priority.