Assessment of Outcomes After Limberg Flap Reconstruction for Scrotal Defects in Patients With Fournier's Gangrene

Mehmet Dadaci, MD; Mehmet Emin Cem Yildirim, MD; Serhat Yarar, MD; Bilsev Ince, MD


Wounds. 2021;33(3):65-69. 

In This Article


Demographic data were analyzed regarding smoking, comorbidities, time of surgery, and time of follow-up. The mean age was 64 years (range, 47–80 years). Eleven patients (37.9%) had diabetes mellitus, 2 (6.8%) had both hypertension and diabetes mellitus, 2 (6.8%) had diabetic nephropathy, and 1 (3.4%) had a diagnosis of incidental lung malignancy. In 4 of the 11 patients with diabetes, one of which also had diabetic nephropathy, dehiscence with seroma occurred.

The mean hospitalization period was 7 days (range, 5–10 days). The average size of the flaps was 11 cm × 15 cm (Figure 2 and Figure 3). Hemovac drains were removed on the second postoperative day; average fluid in drain was 15 μL/day. Dehiscence with seroma of the recipient site was detected in 4 (13.7%) patients on postoperative days 4 and 5. No complications of donor sites were detected. After the wound care period, the flaps were revised, and the defect areas were again repaired by primary closure.

Figure 2.

(A) View of an example of bilateral scrotal defect prior to operation. (B) View of the bilateral Limberg flap immediately after harvesting. (C) Immediate postoperative view of the patient who had hemiscrotal defect. (D) Recovery of the patient at 1 year following operation.

Figure 3.

(A) View of unilateral scrotal defect prior to operation. (B) Recovery of the patient at 1 year following operation.

The mean follow-up period was 16 months (range, 12–26 months). Despite poor patient self-care, no postoperative infections developed in any patient, and no partial or total flap loss was observed.