Introduction and Objective: The lethal necrotizing fasciitis, Fournier's Gangrene, is initially managed with resuscitation, broad-spectrum antibiotics, and aggressive surgical debridement. While the initial management steps are widely described, the subsequent steps in management of skin loss are sparse. Our objective was to focus on a way to reconstruct the penile shaft skin loss requirement of a patient who underwent wide surgical debridement.

Methods: A single case was documented and followed through the progression of presentation, treatment, and to recovery. The primary focus was to focus on the reconstruction of the penile shaft skin. The combined planning and efforts of genitourinary and plastic surgery were used to reconstruct the penile shaft skin using a split thickness skin graft from the lateral thigh. Results A split thickness skin graft from the lateral thigh demonstrated early viability in reconstructing the skin requirement to the penile shaft. After wide surgical debridement during the treatment of Fournier's Gangrene, a penis was tunneled into a viable skin flap of the suprapubic fat pad. The penis maintained its anatomic function during the healing process. Ultimately, we were able to un-tunnel the penis and found early split thickness skin graft success in penile reconstruction.

Conclusion: Complete penile shaft skin loss can be managed acutely with tunneling in the suprapubic fat pad, and can be reconstructed with a split thickness skin graft from the lateral thigh.