Özcan Öcük1, Fatma Hilal Yağın2, Orhan Gazi Dinç1, Cemal Fırat1. 1. Department of Plastic Reconstructive and Aesthetic Surgery, İnönü University, Medical Faculty, Malatya, Turkey. 2. Department of Biostatistics and Medical İnformatics, İnönü University, Medical Faculty, Malatya, Turkey.
Abstract
Background: Fournier gangrene (FG) is a necrotizing fasciitis involving perianal and abdominal regions. It progresses quickly and requires urgent intervention. With the use of vacuum-assisted closure (VAC) treatment applied during clinical follow-up and the use of superomedial thigh flap in the region, the treatment is completed with an effective, functional, and rapid approach. This study examines the clinical details of this method for reconstruction. Methods: The study included 15 patients who underwent superomedial thigh flap in VAC treatment reconstruction for tissue defect after FG debridement from 2016 to 2020. The patients were examined in the form of clinical evaluation with hospital admission and surgical evaluation in the postop process. Results: In patients with wound maturation and sufficient granulation, superomedial thigh flap application followed by VAC treatment soon after shortened the operation time, shortened the postop drain time, and provided effective treatment of dead space. An aesthetic and functional result was obtained with the proximity of the flap to the area. In addition, due to the sensory branches present in the flap, a sensory result was obtained according to the ratio of flap size. Conclusions: Superomedial thigh flap provides a practical, effective, and fast solution to the tissue defect that occurs after FG debridement. Effective results can be obtained when combined with VAC therapy.
Background: Fournier gangrene (FG) is a necrotizing fasciitis involving perianal and abdominal regions. It progresses quickly and requires urgent intervention. With the use of vacuum-assisted closure (VAC) treatment applied during clinical follow-up and the use of superomedial thigh flap in the region, the treatment is completed with an effective, functional, and rapid approach. This study examines the clinical details of this method for reconstruction. Methods: The study included 15 patients who underwent superomedial thigh flap in VAC treatment reconstruction for tissue defect after FG debridement from 2016 to 2020. The patients were examined in the form of clinical evaluation with hospital admission and surgical evaluation in the postop process. Results: In patients with wound maturation and sufficient granulation, superomedial thigh flap application followed by VAC treatment soon after shortened the operation time, shortened the postop drain time, and provided effective treatment of dead space. An aesthetic and functional result was obtained with the proximity of the flap to the area. In addition, due to the sensory branches present in the flap, a sensory result was obtained according to the ratio of flap size. Conclusions: Superomedial thigh flap provides a practical, effective, and fast solution to the tissue defect that occurs after FG debridement. Effective results can be obtained when combined with VAC therapy.