{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,5]],"date-time":"2026-10-05T22:57:07Z","timestamp":1791241027039,"version":"4.1.0"},"reference-count":19,"publisher":"Georg Thieme Verlag KG","issue":"05","license":[{"start":{"date-parts":[[2026,7,6]],"date-time":"2026-07-06T00:00:00Z","timestamp":1783296000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Arch Plast Surg"],"published-print":{"date-parts":[[2026,9]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>Perineal reconstruction in males can be challenging due to the complex anatomy and the potential for complications such as infection, hematoma, and wound dehiscence. In this retrospective case series, we present seven patients who underwent perineal reconstruction between 2020 and 2023 using bilateral scrotal flaps. All defects were secondary to debridement for Fournier's gangrene. In patients with defects involving up to 70% of the total scrotal surface and with sufficient intact scrotal tissue preserved superiorly and inferiorly, reconstruction was performed using bilateral trapezoid-like scrotal flaps based on perforators of the anterior and posterior scrotal arteries. The mean follow-up period was 6 months. Longer-term follow-up was not consistently available for all patients due to loss to follow-up. Nevertheless, selected cases were followed up for 1 year, as demonstrated in the clinical figures. Clinical outcomes were evaluated in seven patients enrolled in the study. The median operative time was 48 (43.5\u201353.5) minutes. The median length of hospital stay was 3 (2.5\u20134.0) days. Complete healing time was recorded as 19 (16.5\u201321.0) days. All flaps used for tissue coverage were successful. Among the observed complications, wound dehiscence was identified as the most prevalent, which occurred in three of seven patients (42.9%) and was managed successfully with local wound care and minor debridement. No partial or total flap loss was observed. Due to its short operating time, low donor site complication rate, and favorable tissue match, the trapezoid-like flap may represent a practical and reliable option in selected patients.<\/jats:p>","DOI":"10.1055\/a-2875-2047","type":"journal-article","created":{"date-parts":[[2026,7,6]],"date-time":"2026-07-06T23:24:34Z","timestamp":1783380274000},"page":"402-406","source":"Crossref","is-referenced-by-count":0,"title":["Bilateral Trapezoid-Like Scrotal Flaps for Reconstruction of Partial Scrotal Defects after Fournier's Gangrene"],"prefix":"10.1055","volume":"53","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-7792-4389","authenticated-orcid":false,"given":"Yusuf Alper","family":"Ayta\u00e7","sequence":"additional","affiliation":[{"name":"Kocaeli City Hospital, Kocaeli, Turkey","place":["Izmit"],"department":["Department of Plastic, Reconstructive and Aesthetic Surgery"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0004-1503-4251","authenticated-orcid":false,"given":"Mustafa Canberk","family":"G\u00fcrb\u00fcz","sequence":"additional","affiliation":[{"name":"Reconstructive and Aesthetic Surgery, Kocaeli University Hospital, Kocaeli, Turkey","place":["\u0130zmit"],"department":["Department of Plastic"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0572-1248","authenticated-orcid":false,"given":"Emrah Ka\u011fan","family":"Ya\u015far","sequence":"additional","affiliation":[{"name":"Reconstructive and Aesthetic Surgery, Kocaeli University Hospital, Kocaeli, Turkey","place":["\u0130zmit"],"department":["Department of Plastic"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3225-7356","authenticated-orcid":false,"given":"Ceyhun","family":"Uzun","sequence":"additional","affiliation":[{"name":"Reconstructive and Aesthetic Surgery, Kocaeli University Hospital, Kocaeli, Turkey","place":["\u0130zmit"],"department":["Department of Plastic"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5521-7173","authenticated-orcid":false,"given":"Murat \u015eahin","family":"Alag\u00f6z","sequence":"additional","affiliation":[{"name":"Reconstructive and Aesthetic Surgery, Kocaeli University Hospital, Kocaeli, Turkey","place":["\u0130zmit"],"department":["Department of Plastic"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"194","published-online":{"date-parts":[[2026,7,6]]},"reference":[{"issue":"06","key":"ref1","doi-asserted-by":"crossref","first-page":"765","DOI":"10.1097\/SAP.0b013e3181ba5485","article-title":"Fournier gangrene: a review of 41 patients and strategies for reconstruction","volume":"64","author":"S Y Chen","year":"2010","journal-title":"Ann Plast Surg"},{"issue":"02","key":"ref2","first-page":"e22671","article-title":"Various options for scrotal reconstruction: A prospective observational study","volume":"14","author":"R Maurya","year":"2022","journal-title":"Cureus"},{"issue":"03","key":"ref3","doi-asserted-by":"crossref","first-page":"327","DOI":"10.1055\/a-2166-8783","article-title":"Posttraumatic scrotal reconstruction with a pedicled \u201cextended\u201d superficial circumflex iliac artery perforator flap: A case report","volume":"51","author":"L Sisternas Hern\u00e1ndez","year":"2024","journal-title":"Arch Plast Surg"},{"key":"ref4","first-page":"e18","article-title":"Reconstruction of defects after Fournier gangrene: A systematic review","volume":"15","author":"L S Karian","year":"2015","journal-title":"Eplasty"},{"issue":"04","key":"ref5","doi-asserted-by":"crossref","first-page":"800","DOI":"10.1016\/j.sxmr.2022.05.002","article-title":"Genital reconstruction following Fournier's gangrene","volume":"10","author":"P Michael","year":"2022","journal-title":"Sex Med Rev"},{"issue":"03","key":"ref6","doi-asserted-by":"crossref","first-page":"179","DOI":"10.1055\/s-0031-1281487","article-title":"Normal penile, scrotal, and perineal anatomy with reconstructive considerations","volume":"25","author":"M E Dwyer","year":"2011","journal-title":"Semin Plast Surg"},{"key":"ref7","first-page":"46","article-title":"Fournier's gangrene: a review of 110 cases for aetiology, predisposing conditions, microorganisms, and modalities for coverage of necrosed scrotum with bare testes","volume":"121","author":"A M Bhatnagar","year":"2008","journal-title":"N Z Med J"},{"issue":"02","key":"ref8","doi-asserted-by":"crossref","first-page":"e226530","DOI":"10.1136\/bcr-2018-226530","article-title":"Scrotal necrosis and no Fournier's in sight: a rare case of juvenile gangrenous vasculitis","volume":"12","author":"J Nettleton","year":"2019","journal-title":"BMJ Case Rep"},{"issue":"03","key":"ref9","doi-asserted-by":"crossref","first-page":"213","DOI":"10.4081\/aiua.2020.3.213","article-title":"Fatal infections in andrology. Atypical clinical presentation of a Fournier's disease","volume":"92","author":"V Olivieri","year":"2020","journal-title":"Arch Ital Urol Androl"},{"issue":"03","key":"ref10","doi-asserted-by":"crossref","first-page":"354","DOI":"10.1016\/0007-1226(84)90078-X","article-title":"Surgical reconstruction of the sequelae of penile and scrotal gangrene: a plea for simplicity","volume":"37","author":"S Parkash","year":"1984","journal-title":"Br J Plast Surg"},{"issue":"06","key":"ref11","doi-asserted-by":"crossref","first-page":"523","DOI":"10.1097\/00000637-197912000-00006","article-title":"Scrotal reconstruction in Fournier syndrome","volume":"3","author":"E D Altchek","year":"1979","journal-title":"Ann Plast Surg"},{"issue":"01","key":"ref12","first-page":"e1389","article-title":"Scrotal reconstruction with superomedial fasciocutaneous thigh flap","volume":"45","author":"D Francisco Mello","year":"2018","journal-title":"Rev Col Bras Cir"},{"issue":"01","key":"ref13","doi-asserted-by":"crossref","first-page":"86","DOI":"10.1097\/00000637-199001000-00016","article-title":"Scrotal reconstruction following Fournier's gangrene using the medial thigh fasciocutaneous flap","volume":"24","author":"G G Hallock","year":"1990","journal-title":"Ann Plast Surg"},{"issue":"03","key":"ref14","first-page":"65","article-title":"Assessment of outcomes after Limberg flap reconstruction for scrotal defects in patients with Fournier's gangrene","volume":"33","author":"M Dadaci","year":"2021","journal-title":"Wounds"},{"issue":"09","key":"ref15","doi-asserted-by":"crossref","first-page":"1055","DOI":"10.1016\/j.bjps.2006.09.005","article-title":"Unilateral gracilis myofasciocutaneous advancement flap for single stage reconstruction of scrotal and perineal defects","volume":"60","author":"H Hsu","year":"2007","journal-title":"J Plast Reconstr Aesthet Surg"},{"issue":"03","key":"ref16","doi-asserted-by":"crossref","first-page":"e2714","DOI":"10.1097\/GOX.0000000000002714","article-title":"Tissue expander scrotal reconstruction","volume":"8","author":"A Hollins","year":"2020","journal-title":"Plast Reconstr Surg Glob Open"},{"issue":"05","key":"ref17","doi-asserted-by":"crossref","first-page":"484","DOI":"10.1016\/S0007-1226(03)00187-5","article-title":"Spermatogenesis after scrotal reconstruction","volume":"56","author":"D Wang","year":"2003","journal-title":"Br J Plast Surg"},{"issue":"02","key":"ref18","doi-asserted-by":"crossref","first-page":"155","DOI":"10.1097\/01.SAP.0000058501.64655.31","article-title":"Use of the scrotal remnant as a tissue-expanding musculocutaneous flap for scrotal reconstruction in Paget's disease","volume":"51","author":"Y C Por","year":"2003","journal-title":"Ann Plast Surg"},{"issue":"04","key":"ref19","doi-asserted-by":"crossref","first-page":"359","DOI":"10.1038\/s41443-021-00468-x","article-title":"Reconstructive surgery of the scrotum: a systematic review","volume":"34","author":"N Schifano","year":"2022","journal-title":"Int J Impot Res"}],"container-title":["Archives of Plastic Surgery"],"original-title":[],"language":"en","link":[{"URL":"http:\/\/www.thieme-connect.de\/products\/ejournals\/pdf\/10.1055\/a-2875-2047.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,10,5]],"date-time":"2026-10-05T22:46:02Z","timestamp":1791240362000},"score":1,"resource":{"primary":{"URL":"http:\/\/www.thieme-connect.de\/DOI\/DOI?10.1055\/a-2875-2047"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,7,6]]},"references-count":19,"journal-issue":{"issue":"05","published-online":{"date-parts":[[2026,10,5]]},"published-print":{"date-parts":[[2026,9]]}},"URL":"https:\/\/doi.org\/10.1055\/a-2875-2047","archive":["Portico","CLOCKSS"],"relation":{},"ISSN":["2234-6163","2234-6171"],"issn-type":[{"value":"2234-6163","type":"print"},{"value":"2234-6171","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,7,6]]}}}