{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,20]],"date-time":"2026-05-20T08:00:49Z","timestamp":1779264049945,"version":"3.51.4"},"reference-count":13,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2019,1,21]],"date-time":"2019-01-21T00:00:00Z","timestamp":1548028800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Microsurgery"],"published-print":{"date-parts":[[2019,3]]},"abstract":"<jats:p>Fournier's gangrene is lethal necrotizing fasciitis that involves the perineum and external genitalia. We describe the case of a 52\u2010year\u2010old man with Fournier's gangrene who underwent reconstruction of an extensive perineoscrotal defect using three pedicled perforator flaps. Three debridement procedures resulted in a skin and soft tissue defect of 36\u2009\u00d7\u200918\u2009cm involving the perineum, scrotum, groin, medial thigh, buttocks, and circumferential perianal area and left the perforating arteries originating from these locations unavailable for reconstruction. We repaired the defect using left deep inferior epigastric artery perforator (DIEP) (29\u2009\u00d7\u20098 cm) and bilateral anterolateral thigh perforator (ALT) flaps (35\u2009\u00d7\u20098 cm and 22\u2009\u00d7\u20097 cm). The flaps reached the defect without tension, and the defect was successfully covered without a skin graft. No postoperative complications occurred except for epidermal necrosis involving a tiny part of the DIEP flap tip. Nine months postoperatively, the patient experienced no impairment of bowel function or hip joint movement. There was also no avulsion or ulceration of the reconstructed perineal skin, and the cosmetic appearances of the healed wound and donor site were satisfactory. The combination of these three perforator flaps enabled us to achieve a satisfactory outcome while avoiding skin grafts.<\/jats:p>","DOI":"10.1002\/micr.30409","type":"journal-article","created":{"date-parts":[[2019,1,22]],"date-time":"2019-01-22T08:46:48Z","timestamp":1548146808000},"page":"263-266","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":16,"title":["Simultaneous deep inferior epigastric and bilateral anterolateral thigh perforator flap reconstruction of an extended perineoscrotal defect in Fournier's gangrene: A case report"],"prefix":"10.1002","volume":"39","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-7833-3524","authenticated-orcid":false,"given":"Hideki","family":"Kadota","sequence":"first","affiliation":[{"name":"Department of Plastic and Reconstructive Surgery Kyushu University Hospital  Fukuoka Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kenta","family":"Momii","sequence":"additional","affiliation":[{"name":"Department of Emergency and Critical Care Center Kyushu University Hospital  Fukuoka Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Masuo","family":"Hanada","sequence":"additional","affiliation":[{"name":"Department of Plastic and Reconstructive Surgery Kyushu University Hospital  Fukuoka Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kenichi","family":"Kamizono","sequence":"additional","affiliation":[{"name":"Department of Plastic and Reconstructive Surgery Kyushu University Hospital  Fukuoka Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yusuke","family":"Inatomi","sequence":"additional","affiliation":[{"name":"Department of Plastic and Reconstructive Surgery Kyushu University Hospital  Fukuoka Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kana","family":"Hisanaga","sequence":"additional","affiliation":[{"name":"Department of Plastic and Reconstructive Surgery Kyushu University Hospital  Fukuoka Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sei","family":"Yoshida","sequence":"additional","affiliation":[{"name":"Department of Plastic and Reconstructive Surgery Kyushu University Hospital  Fukuoka Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kippei","family":"Ogaki","sequence":"additional","affiliation":[{"name":"Department of Surgery and Science, Graduate School of Medical Sciences Kyushu University  Fukuoka Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Keijiro","family":"Kiyoshima","sequence":"additional","affiliation":[{"name":"Department of Urology, Graduate School of Medical Sciences Kyushu University  Fukuoka Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2019,1,21]]},"reference":[{"key":"e_1_2_4_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.urology.2014.06.023"},{"key":"e_1_2_4_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.bjps.2015.11.019"},{"key":"e_1_2_4_4_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.bjps.2011.04.013"},{"key":"e_1_2_4_5_1","doi-asserted-by":"publisher","DOI":"10.1097\/PRS.0000000000000008"},{"key":"e_1_2_4_6_1","doi-asserted-by":"publisher","DOI":"10.1002\/micr.30152"},{"key":"e_1_2_4_7_1","first-page":"e18","article-title":"Reconstruction of defects after Fournier gangrene: A systematic review","volume":"15","author":"Karian L. 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