Posterior thigh flap in the reconstruction of the perineum and scrotum after Fournier's gangrene.

OBJECTIVE

The posterior thigh flap is a fasciocutaneous flap predominantly based on perforating branches of the profunda femoris artery and the medial circumflex femoral artery, with additional vascular supply from perforators of the inferior gluteal artery. It can be used for reconstruction of perineal defects.

METHOD: We describe the case of a 40-year-old man with extensive Fournier's gangrene resulting in complete loss of perineal skin coverage, the entire scrotum, and a large portion of penile skin. After radical necrectomies, intensive resuscitation for septic shock, and supportive therapy including hyperbaric oxygenation, the defect was reconstructed using bilateral posterior thigh flaps. All procedures were in accordance with the Helsinki Declaration.

RESULTS

The postoperative course was uneventful. Both flaps remained fully viable, and donor sites healed per primam. No further necrectomy or surgical revision was needed.

CONCLUSION

The posterior thigh flap represents a reliable and safe method for reconstruction of extensive perineal defects with acceptably low donor-site morbidity.