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KMID : 1144920170130020057
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Journal of Wound Management and Research
2017 Volume.13 No. 2 p.57 ~ p.61
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Acute Perineal Inflammation with Extensive Necrosis: A Devastating Result of Triamcinolone Acetonide Injection for Penile Augmentation
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Na Woong-Gyu
Lim Hyo-Seob
Jung Sung-Won
Koh Sung-Hoon
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Abstract
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Injection of foreign materials for genital augmentation which may induce local infection, ulceration or systemic lipogranuloma embolization resulting in sudden death have been performed in contaminated environment by non-medical practitioners. We present A 36-year-old man who had been given triamcinolone acetonide ointment injection on scrotum and penile shaft followed by skin and soft tissue necrosis. Even though eschar debridement and 10 days of copious irrigation, betadine-soaked dressing and intravenous antibiotics injections were performed, the soft tissue necrosis had been more progressed. Five weeks of daily irrigation and betadine soaking dressing and 3 times of more aggressive debridements under general anesthesia resulted in extensive defect exposing penis, both testes, suprapubic area and both inguinal areas. Bilateral pudendal thigh flaps were done to cover the scrotal defect and remnant area was covered by split-thickness skin graft. On postoperative 1 day, minor congestion was found on left flap tip area which was salvaged with 4% lidocaine topical but resulted in small-sized eschar formation. Additional debridement and closure was performed without tension. Other areas survived without skin loss or dehiscence.
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KEYWORD
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Inflammation, Triamcinolone acetonide, Perineum
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