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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*

doi: 10.1097/01.SAP.0000058501.64655.31
Original Articles

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.

Six patients with subtotal scrotectomy for Paget's disease underwent successful reconstruction by using the scrotal remnant as a stretchable musculocutaneous flap.

Departments of *Plastic Surgery and ‡Urology, Singapore General Hospital; and the †Department of General Surgery, Tan Tock Seng Hospital, Singapore.

Received September 17, 2002 and

in revised form November 26, 2002.

Accepted for publication November 26, 2002.

Address correspondence and reprint requests to Dr Bien-Keem Tan, Department of Plastic Surgery, Singapore General Hospital, Singapore 169608.

Por Y-C, Tan B-K, Hong S-W, Chia S-J, Cheng CWS, Foo C-L, Tan K-C. Use of the scrotal remnant as a tissue-expanding musculocutaneous flap for scrotal reconstruction in Paget's disease.

© 2003 Lippincott Williams & Wilkins, Inc.