Colgajo fasciocutáneo medial de muslo. Una opción reconstructiva para defectos de cobertura escroto-perineales: reporte de dos casos
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Fecha
2021
Autores
Zapata Córdoba, David
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Ediciones Universidad Simón Bolivar
Facultad de Ciencias de la Salud
Facultad de Ciencias de la Salud
Resumen
Antecedentes: Se presentan dos casos clínicos de pacientes manejados en el servicio de cirugía plástica del Hospital Universitario San Jorge de Pereira, que cursaron con gangrena de Fournier, la cual dejó como secuela áreas cruentas importantes perineales, asociadas a perdida escrotal e importante exposición testicular. Teniendo en cuenta el impacto psicológico y funcional de un defecto de cobertura en esta área anatómica, y la importancia reconstructiva de la misma, se propone el uso del colgajo fasciocutáneo medial de muslo como una opción viable de cobertura, con características anatómicas constantes y reproducibles, el cual demuestra ser un método eficaz, basado en la literatura disponible y en los buenos resultados postoperatorios obtenidos.
Objetivos: Descripción del colgajo fasciocutáneo medial de muslo como una opción reconstructiva segura, reproducible y de mínimas complicaciones para defectos de
cobertura escroto-perineales; Reconstrucción con resultados anatómicos y fisiológicos.
Materiales y Métodos: Paciente masculino de 57 años con antecedentes de diabetes mellitus con cuadro clínico de Gangrena de Fournier con secuelas de defecto de cobertura en escroto y pene. Paciente masculino de 44 años con antecedentes de diabetes mellitus con cuadro clínico de gangrena de Fournier con secuelas de defecto de cobertura de escroto y periné. Dadas las características de la lesión y la complejidad al tratarse de la exposición de testículos y las características fisiológicas que conllevan con el objetivo de conseguir una reconstrucción que brinde resultados anatómicos y funcionales se realizó un colgajo fasciocutáneo medial de muslo como método reconstructivo.
Background: Two clinical cases of patients managed in the plastic surgery service of San Jorge of Pereira University Hospital are presented, which transcended with Fournier gangrene, which left as a sequel significant bloody perineal areas, associated with scrotal loss and significant testicular exposure. Taking into account the psychological and functional impact of a coverage defect in this anatomical area, and it's reconstructive importance, the use of the medial fasciocutaneous flap of the thigh is proposed as a viable coverage option, with constant and reproducible anatomical characteristics, which proves to be an effective method, based on the available literature and on the therapeutic postoperative results obtained. Objective: Description of the medial thigh fasciocutaneous flap as a safe and reproducible reconstructive option with minimal complications for scrotal-perineal coverage defects; Reconstruction with anatomical and physiological results. Materials and Methods: Method and materials: A 57-year-old male patient with a history of diabetes mellitus with a clinical picture of Fournier's gangrene with sequelae of a coverage defect in the scrotum and penis. A 44-year-old male patient with a history of diabetes mellitus with a clinical picture of Fournier's gangrene with sequelae of a scrotal and perineum coverage defect. Given the characteristics of the injury and the complexity as it involves the exposure of the testicles and the physiological characteristics that they entail, with the aim of achieving a reconstruction that provides aesthetic and functional results, a medial thigh fasciocutaneous flap was performed as a reconstructive method.
Background: Two clinical cases of patients managed in the plastic surgery service of San Jorge of Pereira University Hospital are presented, which transcended with Fournier gangrene, which left as a sequel significant bloody perineal areas, associated with scrotal loss and significant testicular exposure. Taking into account the psychological and functional impact of a coverage defect in this anatomical area, and it's reconstructive importance, the use of the medial fasciocutaneous flap of the thigh is proposed as a viable coverage option, with constant and reproducible anatomical characteristics, which proves to be an effective method, based on the available literature and on the therapeutic postoperative results obtained. Objective: Description of the medial thigh fasciocutaneous flap as a safe and reproducible reconstructive option with minimal complications for scrotal-perineal coverage defects; Reconstruction with anatomical and physiological results. Materials and Methods: Method and materials: A 57-year-old male patient with a history of diabetes mellitus with a clinical picture of Fournier's gangrene with sequelae of a coverage defect in the scrotum and penis. A 44-year-old male patient with a history of diabetes mellitus with a clinical picture of Fournier's gangrene with sequelae of a scrotal and perineum coverage defect. Given the characteristics of the injury and the complexity as it involves the exposure of the testicles and the physiological characteristics that they entail, with the aim of achieving a reconstruction that provides aesthetic and functional results, a medial thigh fasciocutaneous flap was performed as a reconstructive method.
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Palabras clave
Reconstrucción perineal, Reconstrucción de escroto, Colgajo fasciocutáneo, Colgajo medial de muslo, Gangrena de fournier, Perineal reconstruction, Scrotum reconstruction, Fasciocutaneous flap, Medial fasciocutaneous thigh flap, Fournier gangrene
