Synchronous penile urethra onlay patch and scrotal reconstruction after Fournier's gangrene using medial thigh flaps

Massive penoscrotal skin loss, frequently a sequela of Fournier's gangrene, can sometimes be successfully treated using skin grafts alone. If the urological debridement has been extensive with a concomitant disruption of the urethra, a regional vascularized flap must be introduced. A superiorly based fasciocutaneous flap can be constructed on the medial thigh to provide scrotal reconstruction. The underlying gracilis muscle is an ideal onlay patch for ventral penile defects. Simultaneous use of independent, multiple flaps from a single medial thigh donor site allows coverage of separate penile and scrotal deformities, and leaves only a linear scar.