title: Lotus petal flaps for scrotal reconstruction combined with Integra resurfacing of the penis and anterior abdominal wall following necrotising fasciitis.
abstract: Necrotising fasciitis of the external genitalia following routine circumcision is uncommon. We describe reconstruction of the scrotum with local perforator flaps and a dermal regeneration template (Integra) to cover the penile shaft after debridement. Lotus petal flaps were originally designed to cover vulvo-vaginal defects, but in this instance integrated well with the remaining scrotal sac to produce a good volume neoscrotum for testicular cover. Integra creates an acceptable neodermis usually to cover areas of debrided full thickness burns. In this case, Integra adequately replaced the mobile dermal layer over Bucks fascia over the penis to create a pliable and cosmetically acceptable result with erectile capability.
authors.affiliation: Department of Plastic and Reconstructive Surgery, Castle Hill Hospital, Castle Road, Cottingham, East Yorkshire HU16 5JQ, UK. carolinep@doctors.org.uk
authors.forename: Caroline E
authors.initials: CE
authors.lastname: Payne
authors.forename: Andrew M
authors.initials: AM
authors.lastname: Williams
authors.forename: Nicholas B
authors.initials: NB
authors.lastname: Hart
mesh_terms: D034861:Abdominal Wall / Q000601:surgery*; D000328:Adult; D002809:Chondroitin Sulfates / Q000627:therapeutic use*; D002944:Circumcision, Male / Q000009:adverse effects*; D003094:Collagen / Q000627:therapeutic use*; D019115:Fasciitis, Necrotizing / Q000601:surgery*; D006801:Humans; D008297:Male; D010409:Penile Diseases / Q000382:microbiology / Q000601:surgery*; D010413:Penis / Q000601:surgery; D019651:Plastic Surgery Procedures; D012611:Scrotum / Q000601:surgery; D013290:Streptococcal Infections / Q000601:surgery*; D013524:Surgical Flaps; D016896:Treatment Outcome
chemical_list: C114835:integra artificial skin; D002809:Chondroitin Sulfates; D003094:Collagen