Scrotal Defect Reconstruction using the Anterolateral Thigh Perforator Flap: A Case Series

Infection, trauma, and burns are significant causes of large peno-scrotal defects. Peno-scrotal defects resulting from these causes may pose a major challenge for management and reconstruction. During treatment, multiple debridements may be required, often resulting in significant soft-tissue loss that requires reconstruction. In this case series, 10 patients underwent reconstruction of large penoscrotal defects using a perforator-based Anterolateral Thigh (ALT) flap. All flaps survived well without any major complications. All patients had satisfactory aesthetic outcomes on follow-up. Three patients experienced complications: two had venous congestion managed with leech therapy, and one had wound dehiscence managed with secondary suturing. The pedicled perforator-based ALT flap appears to be a reliable option for reconstruction of large scrotal defects, providing satisfactory aesthetic outcomes with acceptable donor-site morbidity.