Reconstructive Strategy and Classification of Penoscrotal Defects

OBJECTIVE To classify defects in the penoscrotal region according to their specific anatomic sites. METHODS From January 2002 to December 2012, 20 male patients underwent reconstruction for penoscrotal defects. The causative factors were Fournier's gangrene in 12 patients, extramammary Paget's disease in 4, skin tumors in 3, and deformity after a burn injury in 1. The defects were categorized according to their anatomic location: penis (P), and right (r) and left (l) scrotum (Sr and Sl), inguinal area (Ir and Il), and perianal area (Ar and Al). RESULTS Seven patients with defects in the penis received skin grafts. Defects affecting more than 2 anatomic regions or extensive defects (>100 cm(2)) were reconstructed by free tissue transfer. Other defects were reconstructed by perforator-based island flap coverage. All of the flaps survived without complications. CONCLUSION We introduce a classification that provides a simple way to specify the anatomic location and extent of a defect. This classification will permit more effective and straightforward reconstruction in the penoscrotal region. (C) 2014 Elsevier Inc.