AUTHOR=Rossi Severin Alexander , de Schoulepnikoff Camille , Guillier David , Raffoul Wassim , di Summa Pietro Giovanni 

TITLE=Quality of life and sexual health after perineal reconstruction in Fournier gangrene using pedicled anterolateral thigh flaps

JOURNAL=Frontiers in Surgery

VOLUME=Volume 9 - 2022

YEAR=2022

URL=https://www.frontiersin.org/journals/surgery/articles/10.3389/fsurg.2022.994936

DOI=10.3389/fsurg.2022.994936

ISSN=2296-875X

ABSTRACT=Objectives: To assess long-term sexual outcome and quality of life after perineal reconstruction by pedicled anterolateral thigh (ALT) flaps in Fournier’s gangrene.  Postoperative surgical outcomes were assessed, including quality of life and sexual function at long term follow-up (>12 months) with 2 scientifically validated questionnaires. Methods: We conducted a retrospective analysis of a prospectively maintained database. Long-term sexual function and quality of life were assessed by standardised questionnaires. Descriptive statistics were conducted. Results: 8 patients were included in our study, 5 patients responded to quality of life and sexual function analysis. Surgical outcomes were in line with recent literature: one minor complication (minor dehiscence requiring a skin graft), one major complication (flap loss requiring a second, contralateral flap) occurred. No reconstructive failure occurred. Average time to complete wound healing was 17 days (SD +/- 5). Quality of life scores over 70/100 in four out of five categories; social function was rated lowest: patients reported very few residual complaints. Sexual outcome analysis denotes the positive impact of the reconstruction. As expected, Fournier’s Gangrene heavily affected patient’s sexual health. Conclusions: Perineal reconstruction with ALT shows excellent surgical outcomes, quality of life, and good sexual health outcomes. Currently the lack of reliable and relatable data leads to the impossibility to compare different reconstructive procedures. We emphasize that assessing sexual function and quality of life after perineal reconstruction is paramount to weigh reconstructive success.