Single-Stage Reconstruction of Extensive Defects after Fournier's Gangrene with an Exposed Iliac Crest and Testes

Abstract

Fournier's gangrene (FG) is an acute necrotizing fasciitis that involves the skin and subcutaneous tissue on the scrotum, perineum, and abdominal wall [1]. It is a potentially fatal disease, with a reported mortality rate between 3% and 67% [2]. Broad-spectrum antibiotics, aggressive fluid therapy, and early surgical debridement are essential for the management of FG [3]. After primary treatment, FG may produce tissue defects of various sizes that need reconstructive procedures. We experienced a case of extensive defects involving the bilateral groin, pubic area, and scrotum after FG, for which we performed single-stage reconstruction using bilateral pedicled anterolateral thigh (ALT) flaps and gracilis myocutaneous flaps.