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Annals of Plastic Surgery:
Original Articles

Use of the Scrotal Remnant as a Tissue-Expanding Musculocutaneous Flap for Scrotal Reconstruction in Paget's Disease

Por, Yong-Chen MBBS, MRCS*; Tan, Bien-Keem MBBS, FRCS*; Hong, Soo-Wan MBBS, FRCS†; Chia, Sing-Joo MBBS, FRCS†; Cheng, C. W. S. MBBS, FRCS‡; Foo, Chee-Liam MBBS, FRCS*; Tan, Kok-Chai MBBS, FRCS*

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Abstract

Wide excision of extramammary Paget's disease of the penoscrotal region may leave large defects that cannot be closed easily. The authors describe their experience with a series of 6 patients in whom reconstruction of the scrotal defect was undertaken using the scrotal remnant raised as a stretchable musculocutaneous flap. It was observed that as little as a third of the residual scrotum could be expanded to resurface the entire scrotum. All flaps survived completely. Severe scrotal edema and ecchymosis were observed in 1 patient but the symptoms resolved completely with Trendelenburg positioning. The penile defects were resurfaced individually with thick skin grafts. Good-quality take with no chordee was observed in all patients after initial reconstruction. One patient developed penile contracture after reexcision of recurrent disease. Mean follow-up was 22 months (range, 3–60 months). Large defects of as much as two thirds of the scrotum may be reconstructed successfully using the tissue-expanding scrotal musculocutaneous flap.

© 2003 Lippincott Williams & Wilkins, Inc.

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