Thin paraumbilical perforator-based cutaneous island flap for scrotal resurfacing

The main drawback of the thin paraumbilical perforator-based cutaneous island flap is an abdominal scar, whereas the donor-site scars of medial thigh and groin flaps are better hidden by undergarments. For this reason, this flap is especially ideal if medial thigh and groin flaps are unavailable because of concomitant injury. However, applying the thin paraumbilical perforator-based cutaneous island flap to the scrotum offers many advantages over other local flaps that could be used, such as medial thigh or groin flaps. The exit points of the perforators are usually far from the wound, and the length of the vascular pedicle permits an easy transfer, which is very convenient for repair of the scrotum. In addition, despite the flap's large skin territory, donor-site morbidity is minimal because it can be closed primarily. Therefore, to reconstruct a major scrotal defect involving exposed testes, the thin paraumbilical perforator-based cutaneous island flap can be an initial consideration.