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Figure 2: (a) A 30-year-old male with a history of road traffic accident presented with penoscrotal defect, exposed testes, and urethral injury;
(b) debridement and urethroplasty were performed; (c) pedicled gracilis muscle flap was harvested; (d) the gracilis muscle flap was insetted; (e)
split skin grafting over the muscle flap; (f) 1-year postoperative result
Table 1: Details of the patients included in the study
Age Etiology Affected Time of Procedure done Follow-up Complications
(years) side reconstruction (postoperative)
45 Fournier’s gangrene B/L 27 days Local flap advancement with SSG 8 months (satisfactory) -
56 Fournier’s gangrene B/L 20 days Local flap advancement with SSG 12 month (satisfactory) Wound
infection
58 Fournier’s gangrene B/L 31 days Local flap advancement with SSG 6 months (highly -
satisfactory)
51 Fournier’s gangrene B/L 18 days ALT flap 8 month (satisfactory) -
48 Fournier’s gangrene B/L 2 months Local flap advancement with SSG 10 months (unsatisfied) Wound
infection
42 Fournier’s gangrene B/L 28 days Gracilis muscle flap with SSG 9 months (highly -
satisfactory)
47 Fournier’s gangrene B/L 1.5 months Local flap advancement with SSG 15 months (unsatisfied) Dehiscence
52 Fournier’s gangrene B/L 38 days ALT flap 6 months (satisfactory) -
55 Fournier’s gangrene B/L 26 days Medial thigh flap 12 months (highly -
satisfactory)
47 Fournier’s gangrene B/L 2 months ALT flap 5 months (unsatisfi ed) Wound
infection
57 Fournier’s gangrene B/L 2 months Medial thigh flap 8 months (satisfactory) -
51 Fournier’s gangrene B/L 1 month Gracilis muscle flap with SSG 9 months (highly -
satisfactory)
32 Trauma B/L 4 days Gracilis muscle flap with SSG 6 months (highly -
satisfactory)
35 Trauma B/L 3 days Medial thigh flap 12 months (highly -
satisfactory)
30 Trauma B/L 12 days ALT flap 11 months (satisfactory) -
38 Trauma B/L Immediate Local flap advancement with SSG 7 months (unsatisfi ed) Dehiscence
34 Burns B/L 2 months Gracilis muscle flap with SSG 6 months (satisfactory) Dehiscence
42 Burns B/L 1 month Local flap advancement with SSG 8 months (satisfactory) -
SSG: split skin grafting; B/L: bilateral; U/L: unilateral; ALT: anterolateral thigh
[4]
regional and muscle flaps were superior in comparison to of these defects. The spermatic cord can be partially
the local flap advancement with SSG. This study did retracted up into the inguinal canals, and testicles should
not include the assessment of sexual function, and further be sutured together to minimize motion and maximize
studies are needed. graft take. Long-term success with skin grafting for
scrotal injury is excellent, and only 20% of patients require
DISCUSSION significant revisions or reconstructions. However, SSG may
have certain disadvantages such as technical difficulty
SSG for scrotal avulsion injuries was first advocated by at recipient site, poor graft take, contraction and distortion,
Millard and subsequently by Maguina. [4-6] In cases of lack of protective sensation, and less acceptable cosmetic
complete loss of penile and scrotum skin, grafting may results. An SSG does not take if the testes have been
be the most successful and simplest option in the closure stripped of the tunica vaginalis. SSG is a better option for
66 Plast Aesthet Res || Vol 3 || Issue 2 || Feb 29, 2016