両側大腿筋膜張筋皮弁・遊離植皮を用いて皮膚欠損部を再建したフルニエ壊疽

Fournier's Gangrene Treated with Skin Reconstruction Using Bilateral Tensor Fascia Lata Musculocutaneous Flaps and Free Skin Graft

　症例は70歳，男性。主訴は発熱と陰嚢部腫脹・疼痛。フルニエ壊疽による敗血症性ショックを起こしていた。厳重な全身管理と抗生剤投与，抗DIC（播種性血管内凝固症候群）療法およびデブリドマンを施行した。引き続き抗生剤投与と頻回の創洗浄を継続し，約3か月を経て創感染の消退を得た。広汎な皮膚欠損創を両側大腿筋膜張筋皮弁と遊離植皮を用いて再建した。

A 70-year-old man was admitted to our hospital with high grade fever, dark swollen and painful scrotum, spreading to the perineum and lower abdominal wall. The patient had systemic symptoms of sepsis. According to clinical findings, we made a diagnosis of Fournier's gangrene. Haemodynamic support, broad-spectrum antibiotic coverage and surgical debridement were successfully performed. Culture of the discharge from the wound yielded some species of aerobes. Frequent washing of the wound, as well as antibiotic administrations, improved the infection after three months.