RECONSTRUCTION AFTER FOURNIER’S GANGRENE IN MEN
DOI:
https://doi.org/10.11603/2414-4533.2026.1.16078Keywords:
necrotizing soft tissue infection, penis, scrotum, perineal defect, skin graft, fasciocutaneous flapAbstract
The aim of the work: to analyze the reconstructive stage of treatment of Fournier’s gangrene in men, compare our clinical data with recent literature, and demonstrate the possibilities of early staged genital reconstruction using local tissues.
Materials and Methods. A retrospective analysis included 150 patients with surgically confirmed necrotizing fasciitis treated in 1999–2024. Of them, 21 had involvement of the external genitalia, perineum and/or perianal region. A narrative review of publications from 2019 to 2026 on reconstruction after Fournier’s gangrene was also performed.
Results. Fournier’s gangrene was diagnosed in 21 (14.0%) of 150 patients; men accounted for 16 (76.2%) cases. Mortality in this subgroup was 28.6%. In 12 men in whom the infectious process was successfully controlled, the area of skin loss ranged from 80 to 375 cm²; complete loss of penile and scrotal skin was observed in 5 patients and partial loss in 7. Split-thickness skin grafting provided rapid closure of granulating wounds, but was associated with scarring, soft-tissue retraction, and penile deformity. In 5 patients, staged reconstruction was performed with a local skin-subcutaneous tube pedicle flap harvested from the medial thigh. Follow-up at 6–12 months showed satisfactory elastic coverage and restoration of urinary and erectile function. Split-thickness skin grafting remains the basic method for closing flat well-granulating defects, but in the genital-perineal region it often fails to provide the best functional and aesthetic result. The presented case confirms the feasibility of early staged reconstruction immediately after infection control.
Conclusions. Reconstructive strategy after Fournier’s gangrene should be individualized: skin grafting is useful for rapid wound healing, whereas a local tube-pedicle flap allows more complete soft-tissue restoration in a functionally important area.
Received: 05.01.2026 | Revised: 02.02.2026 | Accepted: 23.02.2026
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