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Year : 2019  |  Volume : 27  |  Issue : 2  |  Page : 56-61

Flap based reconstruction for the defects of Fournier's gangrene

Division of Plastic and Reconstructive Surgery, Washington University in St. Louis, Saint Louis, MO, USA

Correspondence Address:
Dr. Utku Can Dolen
Division of Plastic and Reconstructive Surgery, Washington University in St. Louis, Saint Louis, MO
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Source of Support: None, Conflict of Interest: None

DOI: 10.4103/tjps.tjps_61_18

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Background: Fournier's gangrene is necrotizing fasciitis of the perineal area caused by mixed aerobic and anaerobic bacteria. It is a devastating disease that requires serial debridement besides intravenous antibiotic therapy. It often results with extensive and disfiguring soft tissue and skin loss. Plastic surgeons are always consulted for coverage of the defects. Wound coverage varies from simple wound care to free-flap reconstruction. Most of the cases require regional or distant flaps. Vacuum-assisted closure might be a good option until definitive coverage, but its application is quite difficult due to genital organs and anus. In this review article, flap-based reconstruction of the perineogenital area is discussed rather than the pathophysiology or primary treatment of the Fournier's gangrene. Methods: Literature review is performed on Pubmed and Google Scholar in Turkish, English, and French languages. Conclusion: Eradication of the infection and supportive patient care are the most important initial steps in the treatment of the Fournier's gangrene patient. This is followed by functional and aesthetic reconstruction of the resultant defect. The reconstructive ladder, from simple wound care to free-flap surgery, guides the reconstructive decision-making process.

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