{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,22]],"date-time":"2026-01-22T05:24:33Z","timestamp":1769059473485,"version":"3.49.0"},"reference-count":15,"publisher":"International College of Surgeons","issue":"4","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2013]]},"abstract":"<jats:title>Abstract<\/jats:title>\n        <jats:p>Fournier gangrene (FG) is a necrotizing soft tissue infection involving the superficial and fascial planes of the perineum. In many cases of FG, debridement of the scrotum is necessary, leaving definitive management of the exposed testicles a significant surgical challenge. Frequent incidental trauma to the testicles can cause severe pain, especially in laborers. Practical surgical solutions are few and not well detailed. Various options exist, including creating a neoscrotum with adjacent thigh tissue, split-thickness skin grafts (STSGs), or even creating a subcutaneous thigh pocket. We describe a case of abdominal implantation of bilateral testicles for persistent testicular pain in a case where STSGs did not provide adequate protection, adjacent thigh skin was not available for creation of a neoscrotum, and significant cord contracture occurred. We detail the advantages and disadvantages of the commonly described techniques, including this approach, and how in select individuals this may be a suitable alternative.<\/jats:p>","DOI":"10.9738\/intsurg-d-13-00113.1","type":"journal-article","created":{"date-parts":[[2013,11,14]],"date-time":"2013-11-14T15:04:38Z","timestamp":1384441478000},"page":"367-371","source":"Crossref","is-referenced-by-count":6,"title":["Abdominal Implantation of Testicles in the Management of Intractable Testicular Pain in Fournier Gangrene"],"prefix":"10.9738","volume":"98","author":[{"given":"Cyrus C.","family":"Chan","sequence":"first","affiliation":[{"name":"Department of Surgery, University of Toledo Medical Center, Toledo, Ohio, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Khaled","family":"Shahrour","sequence":"additional","affiliation":[{"name":"Department of Urology, University of Toledo Medical Center, Toledo, Ohio, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ronald D.","family":"Collier","sequence":"additional","affiliation":[{"name":"Department of Surgical Critical Care, Cedars-Sinai Medical Center, Los Angeles, California, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Marlene","family":"Welch","sequence":"additional","affiliation":[{"name":"Division of Plastic and Reconstructive Surgery, Department of Surgery, University of Toledo Medical Center, Toledo, Ohio, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Shiliang","family":"Chang","sequence":"additional","affiliation":[{"name":"Division of Plastic and Reconstructive Surgery, Department of Surgery, University of Toledo Medical Center, Toledo, Ohio, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mallory","family":"Williams","sequence":"additional","affiliation":[{"name":"Division of Trauma, Surgical Critical Care, & Acute Care Surgery, Department of Surgery, University of Toledo Medical Center, Toledo, Ohio, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"4721","reference":[{"key":"i0020-8868-98-4-367-b01","series-title":"J Med Chir Pharm","first-page":"251","article-title":"Sur une plaie contuse qui s'est terminee par le spahacele de le scrotum","volume":"20","author":"Baurienne\n              H.","year":"1764","unstructured":"Baurienne\n              H. \n          \n          Sur une plaie contuse qui s'est terminee par le spahacele de le scrotum. J Med Chir Pharm1764;20:251\u2013256"},{"key":"i0020-8868-98-4-367-b02","series-title":"Sem Med","first-page":"345","article-title":"Gangrene foudroyante de la verge","volume":"3","author":"Fournier\n              AJ.","year":"1883","unstructured":"Fournier\n              AJ. \n          \n          Gangrene foudroyante de la verge. Sem Med1883;3:345"},{"issue":"3","key":"i0020-8868-98-4-367-b03","series-title":"Surgeon","first-page":"138","article-title":"Asad Ullah Jan M. Fournier's gangrene: a dreadful disease","volume":"7","author":"Ullah\n              S,","year":"2009","unstructured":"Ullah\n              S, \n            \n              Khan\n              M, \n          \n          Asad Ullah Jan M. Fournier's gangrene: a dreadful disease. Surgeon2009;7(3):138\u2013142"},{"issue":"2","key":"i0020-8868-98-4-367-b04","series-title":"Acta Chir Belg","first-page":"191","article-title":"Evaulation of risk factors and severity of a life threatening surgical emergency: Fournier's gangrene (a report of 15 cases)","volume":"109","author":"Kara\n              E,","year":"2009","unstructured":"Kara\n              E, \n            \n              Muezzinoglu\n              T, \n            \n              Temeltas\n              G, \n            \n              Dincer\n              L, \n            \n              Kaya\n              Y, \n            \n              Sakarya\n              A, \n            \n              Coskun\n              T. \n          \n          Evaulation of risk factors and severity of a life threatening surgical emergency: Fournier's gangrene (a report of 15 cases). Acta Chir Belg2009;109(2):191\u2013197"},{"key":"i0020-8868-98-4-367-b05","series-title":"J Urol","first-page":"944","article-title":"Validation of the Fournier's gangrene severity index in a large contemporary series","volume":"180","author":"Corcoran\n              AT,","year":"2008","unstructured":"Corcoran\n              AT, \n            \n              Smaldone\n              MC, \n            \n              Gibbons\n              EP, \n            \n              Walsh\n              TJ, \n            \n              Davies\n              BJ. \n          \n          Validation of the Fournier's gangrene severity index in a large contemporary series. J Urol2008;180:944\u2013948"},{"issue":"1","key":"i0020-8868-98-4-367-b06","series-title":"Int Surg","first-page":"43","article-title":"Fournier gangrene as a manifestation of undiagnosed metastatic perforated colorectal cancer","volume":"98","author":"Chan\n              CC,","year":"2013","unstructured":"Chan\n              CC, \n            \n              Williams\n              M. \n          \n          Fournier gangrene as a manifestation of undiagnosed metastatic perforated colorectal cancer. Int Surg2013;98(1):43\u201348"},{"key":"i0020-8868-98-4-367-b07","series-title":"South Med Surg","first-page":"527","article-title":"Avulsion and reconstruction of scrotum and penis","volume":"93","author":"Robertson\n              JF.","year":"1931","unstructured":"Robertson\n              JF. \n          \n          Avulsion and reconstruction of scrotum and penis. South Med Surg1931;93:527"},{"issue":"7","key":"i0020-8868-98-4-367-b08","series-title":"J Plast Reconstr Aesthet Surg","first-page":"944","article-title":"Scrotal reconstruction by testicular apposition and wrap-around skin grafting","volume":"64","author":"Tan\n              BK,","year":"2011","unstructured":"Tan\n              BK, \n            \n              Rasheed\n              MZ, \n            \n              Wu\n              WT. \n          \n          Scrotal reconstruction by testicular apposition and wrap-around skin grafting. J Plast Reconstr Aesthet Surg2011;64(7):944\u2013948"},{"issue":"4","key":"i0020-8868-98-4-367-b09","series-title":"J Plast Reconstr Aesthet Surg","first-page":"528","article-title":"Reconstruction of scrotal and perineal defects in Fournier's gangrene","volume":"64","author":"Chen\n              SY,","year":"2011","unstructured":"Chen\n              SY, \n            \n              Fu\n              JP, \n            \n              Chen\n              TM, \n            \n              Chen\n              SG. \n          \n          Reconstruction of scrotal and perineal defects in Fournier's gangrene. J Plast Reconstr Aesthet Surg2011;64(4):528\u2013534"},{"issue":"5","key":"i0020-8868-98-4-367-b10","series-title":"Obstet Gynecol","first-page":"823","article-title":"Short gracilis myocutaneous flaps for vulvovaginal reconstruction after radical pelvic surgery","volume":"74","author":"Soper\n              JT,","year":"1989","unstructured":"Soper\n              JT, \n            \n              Larson\n              D, \n            \n              Hunter\n              VJ, \n            \n              Berchuck\n              A, \n            \n              Clarke-Pearson\n              DL. \n          \n          Short gracilis myocutaneous flaps for vulvovaginal reconstruction after radical pelvic surgery. Obstet Gynecol1989;74(5):823\u2013827"},{"issue":"6","key":"i0020-8868-98-4-367-b11","series-title":"Urology","first-page":"1254","article-title":"A new technique in scrotal reconstruction: short gracilis flap","volume":"61","author":"Kayikcioglu\n              A.","year":"2003","unstructured":"Kayikcioglu\n              A. \n          \n          A new technique in scrotal reconstruction: short gracilis flap. Urology2003;61(6):1254\u20131256"},{"issue":"6","key":"i0020-8868-98-4-367-b12","series-title":"Urology","first-page":"1216","article-title":"Use of tissue expansion for scrotal sac reconstruction after scrotal skin loss","volume":"65","author":"Rapp\n              DE,","year":"2005","unstructured":"Rapp\n              DE, \n            \n              Cohn\n              AB, \n            \n              Gottlieb\n              LJ, \n            \n              Lyon\n              MB, \n            \n              Bales\n              GT. \n          \n          Use of tissue expansion for scrotal sac reconstruction after scrotal skin loss. Urology2005;65(6):1216\u20131218"},{"issue":"1275","key":"i0020-8868-98-4-367-b13","series-title":"N Z Med J","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":"Bhatnagar\n              AM,","year":"2008","unstructured":"Bhatnagar\n              AM, \n            \n              Mohite\n              PN, \n            \n              Suthar\n              M. \n          \n          Fournier's gangrene: a review of 110 cases for aetiology, predisposing conditions, microorganisms, and modalities for coverage of necrosed scrotum with bare testes. N Z Med J2008;121(1275):46\u201356"},{"key":"i0020-8868-98-4-367-b14","series-title":"J Anim Sci","first-page":"804","article-title":"Effect of elevated ambient temperature on testes and blood level and in vitro biosynthesis of testosterone in the ram","volume":"33","author":"Gomez\n              WR,","year":"1971","unstructured":"Gomez\n              WR, \n            \n              Butler\n              WR, \n            \n              Johnson\n              AD. \n          \n          Effect of elevated ambient temperature on testes and blood level and in vitro biosynthesis of testosterone in the ram. J Anim Sci1971;33:804\u2013807"},{"key":"i0020-8868-98-4-367-b15","series-title":"Biol Reprod","first-page":"235","article-title":"Testicular function in boars exposed to elevated ambient temperature","volume":"20","author":"Wettemann\n              RP,","year":"1979","unstructured":"Wettemann\n              RP, \n            \n              Desjardins\n              C. \n          \n          Testicular function in boars exposed to elevated ambient temperature. Biol Reprod1979;20:235\u2013241"}],"container-title":["International Surgery"],"original-title":[],"link":[{"URL":"https:\/\/international-surgery.kglmeridian.com\/view\/journals\/insu\/98\/4\/article-p367.xml","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"http:\/\/meridian.allenpress.com\/international-surgery\/article-pdf\/98\/4\/367\/2347804\/intsurg-d-13-00113_1.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/international-surgery.kglmeridian.com\/downloadpdf\/journals\/insu\/98\/4\/article-p367.xml","content-type":"text\/html","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/international-surgery.kglmeridian.com\/downloadpdf\/journals\/insu\/98\/4\/article-p367.xml","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,7,2]],"date-time":"2025-07-02T18:59:41Z","timestamp":1751482781000},"score":1,"resource":{"primary":{"URL":"https:\/\/international-surgery.kglmeridian.com\/view\/journals\/insu\/98\/4\/article-p367.xml"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2013]]},"references-count":15,"journal-issue":{"issue":"4"},"URL":"https:\/\/doi.org\/10.9738\/intsurg-d-13-00113.1","relation":{},"ISSN":["0020-8868","2520-2456"],"issn-type":[{"value":"0020-8868","type":"print"},{"value":"2520-2456","type":"electronic"}],"subject":[],"published":{"date-parts":[[2013]]}}}