Therapeutic efficacy of combined superficial circumflex iliac artery perforator flap and bilateral pedicled scrotal flaps for perineal defects in male patients with extramammary Paget’s disease

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AimsThis study aimed to investigate the clinical effectiveness of the combined approach involving the superficial circumflex iliac artery perforator (SCIP) flap and bilateral pedicled scrotal flaps in reconstructing significant soft tissue defects in the perineal region following surgical removal of extramammary Paget's disease (EMPD). MethodsA retrospective analysis was conducted on the clinical data of 26 male patients diagnosed with EMPD who underwent burn and plastic surgery at the First People's Hospital of Zhaoqing City between August 2018 and August 2022. The lesions affected the pubic region, penis, and scrotum, with defect sizes ranging from 4cm × 5cm to 17cm × 20cm. All pubic region defects were repaired using the SCIP flap, while scrotal and penile defects were reconstructed using the bilateral pedicled scrotal flaps, preserving scrotal tissue. Follow-up visits were scheduled at 1 month, 3 months, and then every 3 months thereafter. ResultsA total of 26 patients were successfully followed up for a median duration of 28 months (12-60 months). The flaps displayed complete viability with favorable color and texture. Both the donor and recipient sites of the flaps exhibited satisfactory functional and aesthetic outcomes. ConclusionsThe combined utilization of the SCIP flap and bilateral pedicled scrotal flaps represents a straightforward and efficacious strategy for addressing extensive perineal defects after the excision of EMPD in male patients. This procedure ensures adequate blood supply and yields consistently positive results.