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Figure 1: (a) Posttraumatic avulsion injury penoscrotal region; (b) bilateral pedicled gracilis muscle flap harvested for reconstruction of scrotal
tissue; (c) split thickness skin grafting done on the muscle and penile shaft region; (d) early postoperative picture following bilateral gracilis flap
cover; (e) late postoperative picture following bilateral gracilis flap cover

We present our experience with penoscrotal soft tissue loss critically ill patients.
with hyperbaric oxygen therapy as an adjunct.
RESULTS
METHODS
The mean patient age was 41.5 years. Five patients
This retrospective study was undertaken in the department (55.5%) had sustained the soft tissue loss due to trauma.
of plastic surgery, over a period of 2 years from January The cause of necrotizing fasciitis was found in 4
2012 to December 2014. The records of patients who patients (44.4%). The majority of necrotizing soft tissue
underwent scrotal reconstruction were reviewed. Nine infection was referred to plastic surgery following initial
patients with scrotal or penile injury and infection were debridement in general surgery or urology department.
enrolled in the study. Informed written consent was All of the patients underwent multiple surgical
obtained from all the patients enrolled in the study. Age debridements when required and several reconstruction
of the patients ranged 20-60 years. Five patients had techniques were utilized as mentioned in Table 1. The
traumatic loss of scrotal skin and 4 resulted following median length of hospital stay was 42.5 days. Healing
necrotizing soft tissue infection. No patient had injuries was complete in all patients with minor complications
or infection to urethra. Patients with necrotizing soft as partial skin graft loss in two patients, which required
tissue infection of the scrotum were diabetic. Rest of repeated skin grafting procedure. Patients were
the patients did not have any comorbidity. All patients satisfactory in terms of aesthetic outcome and sexual life
underwent hyperbaric oxygen therapy before and during the follow up period.
following surgery. Patient requiring intensive care unit
admission was excluded from our study, as we are not Case 1
equipped with hyperbaric oxygen therapy settings in A 23-year-old patient came with avulsion injury due
274 Plast Aesthet Res || Volume 3 || August 12, 2016