Scrotum reconstruction with the anterolateral (ALT) thigh flap

Scrotum reconstruction is challenging. Both the functional and cosmetic outcome are considered. Many reconstructive methods have been described, from burying the exposed testicles into a subcutaneous pocket to local musculocutaneous or fasciocutaneous flaps. We report our experience of treating three patients for scrotal reconstruction by using the anterolateral thigh island flap. Three patients received scrotum reconstruction with the anterolateral thigh island flap from 2003 to 2007. Two of them had Fournier’s gangrene and one had hidradenitis suppurativa. In two occasions a “true” perforator flap was used and in one a small muscle cuff of the vastus lateralis muscle was also included. All three flaps were successful. One patient had a proximal donor site wound dehiscence due to inadequate drainage. Simple conservative treatment resolved the problem. No patient had any functional donor site morbidity. We conclude that the anterolateral thigh flap is a valuable tool in reconstruction of the scrotum. It should be considered as a sound alternative within the available reconstructive procedures.