A SIMPLE TECHINIQUE TO IMPROVE RESIDUAL SKIN PLASTICITY FOR SCROTAL RECONSTRUCTION IN FOURNIER'S GANGRENE

Abstract

A 50 years-old man developed 24 hours after hemorroidectomy a severe Fournier's gangrene of the scrotum necessitating surgical exeresis of more than 2/3 of scrotal skin followed by hyperbaric oxygen therapy. After the resolution of the septic phase, scrotum reconstruction was obtained by tissue expansion to avoid more invasive advanced reconstructive techniques. The procedure consisted of an enzymatic and mechanical debridement and progressive skin expansion by package of gauzes of increasing volume covered with a collagenase-cloramphenicol ointment (Iruxol - Smith & Nephew, Italy), then closing the wound edges by temporary stitches to put under tension the skin. The reestablishement of the natural elasticity of the scrotal skin was obtained in ten days and at the final closure of the wound edges an acceptable optimal aesthtic result was achieved.