The Gracilis Muscle Flap Technique is an Aesthetic and Functional Option in Fournier's Gangrene: Clinical Case

Abstract

Introduction. The scrotum is a covering of skin that covers and protects the testicles. Although it is not common, some bacterial infections of this skin can extend to deep tissues and produce a severe entity known as Fournier's gangrene.

Clinical case. A 62-year-old male patient arrives at the Emergency Department due to increased scrotal volume with extension to the perineal region associated with purulent discharge and fever for one week. The patient has type 2 diabetes mellitus of 10 years duration, with poor control despite consuming oral hypoglycemic agents. He has also had high blood pressure for two years, managed with Losartan 50 mg/day. They observed secretion from perianal fistula drainage and uncomplicated external hemorrhoids. Laboratories: Glucose 260 mg/dL, BUN 23 mg/dL, Urea 49.5 mg/dL, Cr 1.50 mg/dL, Leukocytosis 33.39 x 109/L, Hb 9.9 g/dL, Hct. 30.3%.

Discussion. The management of Fournier's gangrene includes both pharmacological measures, such as the use of antibiotic therapy and surgical management. Autologous partial skin graft is one of the most used techniques due to its safety and versatility and the extensive availability of donor areas. The process consists of obtaining a portion of skin taken from a donor area, preferably the thighs, which is obtained with a dermatome, after which the graft is meshed, increasing its extension and increasing the surface to be covered. As for negative aspects, there is possibly an unaesthetic result and possible retractions. Despite this, most authors point to a good result with this technique.