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Original Article Plastic and Aesthetic Research

Peno-scrotal soft tissue loss: a need

for multidisciplinary and multimodal

integration

Pradeoth Korambayil Mukundan, Prashanth Varkey Ambookan, Ragu Angappan,
Vinoth Kumar Dilliraj

Department of Plastic Surgery and Burns, Bahrain Defence Force Royal Medical Services, East Riffa 38285, Bahrain.
Correspondence Author: Dr. Pradeoth Korambayil Mukundan, Department of Plastic Surgery and Burns, Bahrain Defence Force Royal
Medical Services, East Riffa 38285, Bahrain. E-mail: pradeoth@gmail.com

ABSTRACT
Aim: Scrotal soft tissue loss is a part of the challenging conditions for plastic surgeon. The non-
availability of adequate nearby healthy soft tissue and its probability of frequent contamination
by excretory substances make the issue of reconstruction complicated. The authors present
their experience with penoscrotal soft tissue loss with hyperbaric oxygen therapy as an adjunct.
Methods: This retrospective study was undertaken in the department of plastic surgery, over a
period of 2 years. Nine patients with scrotal or penile injury and infection were enrolled in the
study. Age of the patients ranged 20-60 years. Five patients had traumatic loss of scrotal skin and
4 resulted following necrotizing soft tissue infection. All patients underwent hyperbaric oxygen
therapy before and following surgery. Results: Healing was complete in all patients with minor
complications as partial skin graft loss in 2 patients. Five patients (55.5%) had sustained the
soft tissue loss due to trauma. The cause of necrotizing fasciitis was found in 4 patients (44.4%).
The mean length of hospital stay was 42.5 days. Conclusion: Management of soft tissue loss of
penoscrotal region requires an organized approach and the utilization of newer modalities for
early recovery of these injuries is of primary need. Operating surgeons should know the various
reconstructive pathways and use of adjunct measures like hyperbaric therapy for early recovery.

Key words:
Scrotal soft tissue loss; necrotizing fasciitis; soft tissue reconstruction; hyperbaric oxygen therapy

INTRODUCTION decrease the time period of healing of scrotal wounds
should be undertaken as the condition may increase
Scrotal soft tissue loss is one of the perplexing conditions the morbidity following these injuries. Most of these
for plastic surgeon. The non-availability of adequate patients suffer multiple co-morbidities and are immune-
nearby healthy soft tissue and its probability of recurrent compromised adding to the complication of such conditions.
faecal and urinary contamination make the issue of
reconstruction complicated. All necessary effort to This is an open access article distributed under the terms of the Creative
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How to cite this article: Mukundan PK, Ambookan PV,
Angappan R, Dilliraj VK. Peno-scrotal soft tissue loss: a need for
DOI: multidisciplinary and multimodal integration. Plast Aesthet Res
10.20517/2347-9264.2015.127 2016;3:273-8.
Received: 17-12-2015; Accepted: 06-06-2016
© 2016 Plastic and Aesthetic Research | Published by OAE Publishing Inc. 273