Scrotal reconstruction using thigh pedicle flaps after scrotal skin avulsion

Reconstruction of major scrotal defects by anterolateral thigh flap

To summarize the indications and applications of anterolateral thigh flaps (ALTP) in reparation and reconstruction of acute scrotum skin deficiency. We report our experience of treating three patients for scrotal reconstruction using the ALTP method from May of 2007 to December of 2010. The flap was completely islanded, tunneled beneath the fascial septa below the rectus femoris, and placed into the defect. The resulting reconstruction provided a tension-free, cosmetically appealing scrotum with complete testicular coverage. There were no perioperative or postoperative complications. Spermatogenesis (sperm count levels), and sexual function (IIEF) were not changed significantly. ALTP represent an excellent reconstruction option for patients with contaminated perineum. ALTP is available for replacement of the avulsed portion of the scrotal skin resulting in satisfactory shape and color of the penis and scrotum.

Use of a hypogastric flap and split-thickness skin grafting for a degloving injury of the penis and scrotum: A different approach

Penile and scrotal skin avulsions are not common events and are caused usually by accidents with industrial machines or agricultural machines. We report a case of a 27-year-old newly married thin-built patient with avulsion and traumatic degloving of the penile and scrotal skin, with exposure of the corpora cavernosa and copus spongiosum of penis and testes as his loose clothes got entangled in a paddy harvesting machine accidently. Reconstruction was performed using a hypogastric flap and split skin graft, achieving a satisfactory aesthetic result and sexual functions.

The effect of scrotal reconstruction with skin flaps and skin grafts on testicular function

Due to its unique composition, the reconstruction of scrotal skin defects is a major clinical challenge. This study was designed to evaluate the effects of scrotal reconstruction, using skin grafts and skin flaps, on spermatogenesis. In Group 1, the rats did not undergo surgery and were used as controls. In Group 2, after removal of all of the scrotal skin to expose the testicles, the defect was repaired using a skin flap from the right groin region. In Group 3, the reconstruction was achieved using skin grafts. All the rats were killed at 2 months postoperatively and evaluated. The mean wet weights of the testicles in the control group were significantly higher compared with that of the graft group. The mean height of the germinal epithelium was significantly greater in the control and flap groups compared with that of the graft group. The Johnsen score for spermatogenesis in the control group was higher than that in the graft group. The use of flaps resulted in testicular function that was comparable to that of the control group, whereas the use of grafts resulted in diminished testicular function. Therefore, we suggest that flaps may be the first choice for scrotal reconstruction.