Scrotal reconstruction using thigh pedicle flaps: long-term follow-up of 12 cases

Genital skin loss in men may be caused by avulsion injuries of the penis and scrotum or by gangrene of the male genitalia. Reconstruction of the scrotum after complete loss of the overlying skin is a challenging problem. We report our experience on the management of this problem.

Medical records of all male patients with massive scrotal skin loss and exposed testes treated at Ramathibodi Hospital and Noparat Rajthanee Hospital from 1990 to 1999 were reviewed. The etiologies of scrotal skin loss, technique of treatment, post-operative consequence as well as complications were noted.

Twelve patients were described in this study. Nine patients had avulsion injuries of the penile and scrotal skin secondary to agricultural machinery accidents. Three patients were after extensive debridement of Fournierrís gangrene. The exposed testes had been placed in thigh pouches and scrotal reconstruction using thigh pedicle flaps was done 4-6 weeks later. No immediate and delayed complications were detected in all of the patients. They recovered without any sequelae and had a satisfactory cosmetic result.

Extensive scrotal skin loss should be immediately treated surgically. Implantation of the exposed testes in the upper thigh pouch and delayed reconstruction of the scrotum using thigh pedicle flaps can provide excellent results