Problematic ulcerative lesions in sexually transmitted diseases: surgical management

Chronic intractable ulcerative lesions, with or without lymphedema, are occasional sequelae of various sexually transmitted diseases that lead to gross morbidity. This study of 15 such cases, including seven of granuloma inguinale, four of lymphogranuloma venereum, three of confined lesions (granuloma inguinale and lymphogranuloma venereum), and one of sexually transmitted amebic ulcer of the penis, employed surgical procedures aimed at sound healing after a single-stage procedure. The surgical techniques included full skin cover by direct flaps, myocutaneous flaps, sliding flaps (floating island), and excision of the involved rectum (two cases). Nine lesions healed by primary intention, one by spontaneous contraction of the wound, and two needed limited secondary procedures. In view of the paucity of literature on the subject, an argument is made for identifying such cases and saving them from prolonged morbidity by a suitable single-stage surgical procedure.