Management of Perineo-Scrotal Tissue Loss Following Fournier’s Gangrene: Experience of the Department of Plastic and Reconstructive Surgery at Ibn Sina University Hospital, Rabat

Abstract: Introduction: Fournier’s gangrene is a rare but severe necrotizing bacterial dermohypodermitis that requires extensive surgical debridement, often exposing the genital organs and resulting in significant tissue loss. Objective: To describe our experience in the coverage of perineo-scrotal defects following Fournier’s gangrene and to analyze the functional and aesthetic outcomes achieved. Methods: A retrospective study was conducted between August 2020 and August 2024 at Ibn Sina University Hospital in Rabat. Epidemiological, clinical, and therapeutic data from 38 patients were analyzed. Results: The mean age was 54 years (range 20–75). The tissue loss was isolated to the perineo-scrotal region in 61% of cases. Skin grafting was the most commonly used coverage method, followed by direct suturing. Advancement flaps were preferred when scrotal skin was available. Postoperative outcomes were uneventful in the majority of cases. The postoperative satisfaction rate was 94%. Minor complications were observed in 11% of patients. Conclusion: Perineo-scrotal reconstruction following Fournier’s gangrene primarily relies on skin grafting and direct suturing with advancement flaps, allowing for adequate coverage, fertility preservation, and favorable aesthetic outcomes.