ABSTRACT
Objective
To demonstrate a technique for performing orchidopexy and split-thickness skin graft
for patients with deficient scrotal skin after debridement for Fournier's gangrene.
This is an alternative strategy to healing by secondary intention, flaps, or testicular
thigh pouches.
Methods
Orchidopexy was performed after initial debridement using interrupted Vicryl sutures
to bring the testicles and inferior penis together. During this procedure, the testicles
and spermatic cord were mobilized, and redundant spermatic cord was coiled under the
abdominal wall. Once patients were medically stable with no additional planned debridement,
a split-thickness skin graft at a depth of 18/1000 inch and meshed 2:1 was applied
to the scrotum. The graft was covered with a bolster dressing that was sutured to
the scrotum for 5 to 7 days. An inpatient stay was not required after skin graft and
bolster placement. Patients were evaluated for cosmetic appearance, pain, and need
for revision.
Results
From 2017-2021, 10 patients underwent orchiopexy and split-thickness skin graft to
the scrotum. Etiology of Fournier's gangrene included diabetes (5), urethral stricture
(2), alcohol abuse (2), unknown (1). Median age was 56 years and median BMI was 30
kg/m2. Median length of stay after orchidopexy and skin graft were 18 and 9 days respectively.
At a median follow-up of 8 months, there were no issues with chronic pain, discomfort,
or need for further intervention.
Conclusion
Orchidopexy and split-thickness skin graft to scrotum is a feasible method of scrotal
reconstruction that leads to acceptable clinical and cosmetic results, and does not
result in prolonged inpatient hospitalization. Future research should focus on long
term sexual function and quality of life outcomes.
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Article info
Publication history
Published online: February 10, 2021
Accepted:
February 3,
2021
Received:
January 21,
2021
Identification
Copyright
© 2021 Elsevier Inc. All rights reserved.
