-Case Reports-

Reconstruction Using Negative Pressure Wound Therapy with a Cotton Filler for Fixation of Male Genital Skin Grafts in Cases of Fournier's Gangrene

Yuki Ideguchi¹, Shimpei Ono², Shintaro Kaneyuku¹, Taishi Murakami¹ and Rei Ogawa²

¹Department of Plastic Surgery, Aidu Chuo Hospital, Fukushima, Japan
²Department of Plastic, Reconstructive, and Aesthetic Surgery, Nippon Medical School Hospital, Tokyo, Japan

The reliable engraftment of skin grafts into areas with complex shapes can be challenging. Here, we report a case of successful fixation of a genital skin graft using negative pressure wound therapy (NPWT) with RENASYS^© Cotton Filler. A 44-year-old male with no relevant medical history underwent split-thickness skin grafting for a genital skin defect caused by Fournier's gangrene. A 0.4-mm sheet graft was applied for the penile skin defect, while 0.4-mm 1.5 times mesh grafting was applied for the testis and spermatic cord. NPWT with a cotton filler was used for seven days of fixation. No postoperative pain or stool contamination was observed. Although a small area of partial necrosis developed, the lesion healed with conservative treatment. Six months after surgery, there was no scar contracture, urination disorder, or pain during erection. Cotton fillers are highly malleable and adaptable, allowing for simple and reliable fixation of skin grafts in complex areas. Moreover, NPWT for genital graft fixation avoids contamination from stools. Therefore, we recommend fixation using NPWT with a cotton filler for genital skin grafting.

J Nippon Med Sch 2024; 91: 595-599

Keywords
cotton filler, gauze based, negative pressure wound therapy, skin graft, genitalia

Correspondence to
Yuki Ideguchi, Department of Plastic Surgery, Aidu Chuo Hospital, 1-1 Tsurugamachi, Aizuwakamatsu, Fukushima 965-0011, Japan
ideguchiyuki121@gmail.com

Received, June 27, 2023
Accepted, October 25, 2023