A new technique in scrotal reconstruction: short gracilis flap

The gracilis flap is commonly used for the reconstruction of the genitalia and scrotum, but the procedure has problems owing to a pedicle away from the pubic tubercle and a bulky nature. A new use of this flap without including its pedicle has been described as the "short gracilis flap" and has been used for vulvovaginal, perineal, and inguinal reconstruction with considerable results. However, scrotal use has not yet been mentioned.

We applied the flap in 2 cases of Fournier's gangrene for scrotal reconstruction. The flap dissection was straightforward. Because one uses the vascularity through the origin of the muscle on the pubic bone, the short gracilis flap has the advantage of greater mobility. No "dog ears" or bulky zones because of pedicle protection are created. The skin island is transposed more proximally than with the conventional gracilis flap where the circumference of the thigh is greater, thus allowing primary closure easily. The flap does not have any vascular problems. The donor site scars can be hidden more easily, and the flap atrophies significantly with time.

The short gracilis flap may be a good choice for selected cases of scrotal reconstruction.