COLGAJOS BILATERALES DE PÉTALO DE LOTO BASADOS EN PERFORANTES DE LAS ARTERIAS PUDENDAS INTERNAS EN EL TRATAMIENTO DE LA GANGRENA DE FOURNIER: UN ENFOQUE INNOVADOR EN LA PRÁCTICA CLÍNICA
Authors/Creators
-
1.
Pontificia Universidad Javeriana
- 2. Universidad del Norte. Colombia
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3.
Universidad El Bosque
- 4. Pontificia Universidad Javeriana. Colombia
Description
Tipo de artículo: Caso clínico
Introducción: la gangrena de Fournier es una fascitis necrotizante grave que afecta la región perineal y puede ser mortal. Se asocia habitualmente con inmunosupresión, diabetes y otros factores de riesgo, como el consumo perjudicial de alcohol. Su manejo incluye desbridamiento quirúrgico extenso y, en muchos casos, reconstrucción con colgajos cutáneos debido a la pérdida significativa de tejido.
Presentación del caso: hombre de 70 años con antecedentes de insuficiencia cardíaca, hipertensión y enfermedad renal crónica, quien desarrolló gangrena de Fournier secundaria a una perforación colónica después de una herniorrafía inguinoescrotal. El paciente requirió desbridamiento extenso, incluida una orquiectomía derecha. Tras múltiples lavados quirúrgicos, se reconstruyeron los defectos escrotal y perineal mediante colgajos bilaterales de pétalo de loto basados en perforantes de las arterias pudendas internas. Se confeccionaron dos colgajos, uno a cada lado, de 4 × 12 cm cada uno y basado en una perforante de la arteria pudenda interna correspondiente. Además, se obtuvo mediante dermatomo un injerto cutáneo de espesor parcial del muslo izquierdo para cubrir la región peneana. La evolución posoperatoria fue satisfactoria, con adecuada cicatrización de los colgajos y sin complicaciones mayores.
Conclusiones: la reconstrucción con colgajos bilaterales de pétalo de loto ofrece una cobertura eficaz de defectos perineales extensos en pacientes con gangrena de Fournier. Estos colgajos proporcionan vascularización adecuada, preservación de la sensibilidad y resultados estéticos favorables, por lo que constituyen una opción relevante para el manejo reconstructivo.
Abstract (English)
Article type: Clinical case
Introduction: Fournier gangrene is a severe necrotizing fasciitis that affects the perineal region and can be fatal. It is commonly associated with immunosuppression, diabetes, and other risk factors, such as harmful alcohol consumption. Its management includes extensive surgical debridement and, in many cases, reconstruction with skin flaps due to significant tissue loss.
Case presentation: A 70-year-old man with a history of heart failure, hypertension, and chronic kidney disease developed Fournier gangrene secondary to colonic perforation after inguinoscrotal herniorrhaphy. The patient required extensive debridement, including right orchiectomy. After multiple surgical washouts, the scrotal and perineal defects were reconstructed using bilateral lotus petal flaps based on internal pudendal artery perforators. Two flaps were created, one on each side, measuring 4 × 12 cm each and based on a perforator from the corresponding internal pudendal artery. In addition, a split-thickness skin graft was harvested from the left thigh using a dermatome to cover the penile region. The postoperative course was satisfactory, with adequate flap healing and no major complications.
Conclusions: Reconstruction with bilateral lotus petal flaps provides effective coverage of extensive perineal defects in patients with Fournier gangrene. These flaps provide adequate vascularization, preservation of sensation, and favorable aesthetic outcomes, making them a relevant option for reconstructive management.
Files
sanum_v10_n4_a18.pdf
Additional details
Additional titles
- Translated title (English)
- BILATERAL LOTUS PETAL FLAPS BASED ON INTERNAL PUDENDAL ARTERY PERFORATORS IN THE TREATMENT OF FOURNIER GANGRENE: AN INNOVATIVE APPROACH IN CLINICAL PRACTICE
Dates
- Collected
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2026-07-20manuscrito recibido
- Available
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2026-09-02evaluación doble ciego
- Accepted
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2026-10-30publicación en numero de la revista
Software
- Repository URL
- https://revistacientificasanum.com/
- Development Status
- Active
References
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