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Penile Preservation With Subcutaneous Transposition During Fournier's Gangrene

View Article: PubMed Central - PubMed

ABSTRACT

A 50-year-old male with past medical history of diabetes mellitus presented with extensive Fournier’s Gangrene. He had a wide-spread area of involvement and the wound vacuum placement involved the entirety of the phallus. We describe a surgical technique where the penis can be diverted from the site of the wound to allow for more secure wound vacuum placement and future reconstructive options.

No MeSH data available.


Related in: MedlinePlus

Penis immediately after intra-op transposition.
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fig2: Penis immediately after intra-op transposition.

Mentions: The patient was placed in dorsal lithotomy position and the wound VAC was removed (Fig. 1). A standard left orchiectomy was performed due to testicular necrosis. An uninvolved area was identified outside of the wound VAC field in the left suprapubic area. A subcutaneous tunnel was created leading from the suspensory ligament of the penis to the uninvolved area. The phallus was brought up through this tunnel (Fig. 2). Bucks fascia along the mid-phallus was secured to scarpa's fascia with 4 interrupted 2-0 Vicryl sutures and the sub-coronal tissue was sutured to the skin with 3-0 chromic sutures circumferentially. Care was made to ensure there was no twisting or tension on the phallus. The positioning was checked in the dorsal lithotomy position and with hip extension to ensure proper orientation. A wound VAC was successfully replaced per the general surgery team (Fig. 3).


Penile Preservation With Subcutaneous Transposition During Fournier's Gangrene
Penis immediately after intra-op transposition.
© Copyright Policy - CC BY-NC-ND
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC5385576&req=5

fig2: Penis immediately after intra-op transposition.
Mentions: The patient was placed in dorsal lithotomy position and the wound VAC was removed (Fig. 1). A standard left orchiectomy was performed due to testicular necrosis. An uninvolved area was identified outside of the wound VAC field in the left suprapubic area. A subcutaneous tunnel was created leading from the suspensory ligament of the penis to the uninvolved area. The phallus was brought up through this tunnel (Fig. 2). Bucks fascia along the mid-phallus was secured to scarpa's fascia with 4 interrupted 2-0 Vicryl sutures and the sub-coronal tissue was sutured to the skin with 3-0 chromic sutures circumferentially. Care was made to ensure there was no twisting or tension on the phallus. The positioning was checked in the dorsal lithotomy position and with hip extension to ensure proper orientation. A wound VAC was successfully replaced per the general surgery team (Fig. 3).

View Article: PubMed Central - PubMed

ABSTRACT

A 50-year-old male with past medical history of diabetes mellitus presented with extensive Fournier’s Gangrene. He had a wide-spread area of involvement and the wound vacuum placement involved the entirety of the phallus. We describe a surgical technique where the penis can be diverted from the site of the wound to allow for more secure wound vacuum placement and future reconstructive options.

No MeSH data available.


Related in: MedlinePlus