Int érêt du lambeau fasciocutané médial de la cuisse dans la gangrène de Fournier

Conclusion La couverture des pertes de substance périnéoscrotales a été longtemps dominée par l’enfouissement des testicules et la greffe de peau. Certes, ces deux techniques sont simples, mais elles ne sont pas toujours réalisables. Comparé aux autres lambeaux, musculocutanés en l’occurrence, le lambeau fasciocutané médial de cuisse reste un moyen simple, utile, et dont la morbidité est moindre. Il doit occuper une place de choix dans la couverture de telles pertes de substances, notamment chez le sujet âgé, chez qui le désir de procréation n’est plus une priorité. Introduction The authors propose a focus on the management of perineoscrotal defects caused by Fournier's gangrene, and emphasize the importance of the medial thigh fasciocutaneous flap. Patients and methods This a retrospective study of 12 cases of Fournier's gangrene managed initially by intensivists and urologists then addressed to plastic surgeons for skin coverage. The latter was achieved through a medial thigh fasciocutaneous flap, unilateral in some cases, bilateral in others. Results All patients were male, 63 years on average, and the defect was perineoscrotal, associated in three cases with penile skin defect. The medial thigh fasciocutaneous flap was bilateral in 8 cases. We deplore two cases of partial necrosis. Long-term cosmetic results were satisfactory. Conclusion coverage of perineoscrotal defect in Fournier's gangrene was dominated for a long time by burying the test...
Source: African Journal of Urology - Category: Urology & Nephrology Source Type: research