We encountered a case of
Fournier's gangrene complicated with vesicorectocutaneous
fistula that was treated with a pedicled rectus abdominis muscle
flap (pedicled RA m-c flap). A 75-year-old man was admitted with
consciousness disorder and swelling of the scrotum. The patient had noticed swelling of the scrotum 4 days before admission, but he had ignored this condition. The scrotum and the penis appeared necrotic. On the basis of clinical and radiological findings, we diagnosed this condition as
Fournier's gangrene. Surgical
debridement was performed in conjunction with the use of broad-spectrum
antibiotics. After the patient's general condition was improved, the broad defect in the perineal tissue was covered with a pedicled rectus abdominis muscle flap. The flap was successful. In Japan, this is the first case of
Fournier's gangrene complicated with vesicorectocutaneous
fistula that was treated with a pedicled RA m-c flap. In order to determine whether plastic surgery after
debridement shortens the duration of hospitalization, we reviewed the cases of 120 patients with
Fournier's gangrene in Japan. We conclude that plastic surgery after
debridement does not shorten the duration of hospitalization, however, this procedures is very useful to deep and broad defects by
Fournier's gangrene.