ABSTRACT
Background:  Fournier’s gangrene leads to significant scrotal tissue loss, traditionally managed with sheet skin grafts. Recently, meshed grafts have been introduced for improved coverage and healing. Due to limited comparative studies, this research was designed to evaluate outcomes between meshed and sheet skin grafts for scrotal reconstruction.
Objectives: To compare meshed versus sheet skin graft for treatment of loss of scrotum, post Fournier gangrene surgery in terms of patient satisfaction at a tertiary care hospital.  
Duration: Three months w.e.f 08-05-2025 to 07-08-2025
Methodology: After ethical approval, 60 male patients with scrotal skin loss post-Fournier’s gangrene surgery at Services Hospital, Lahore, were enrolled and randomized into two groups: meshed (Group A) and sheet (Group B) skin grafts. After counseling and consent, all underwent standardized graft procedures under general anesthesia, followed by postoperative care and follow-up.  
Results:  The study included 60 patients (mean age 42.10 ± 10.63 years, BMI 25.88 ± 3.65 kg/m²). Group A (meshed graft) showed higher satisfaction (80% vs. 46.7%, p = 0.007) and Genital Perception Scale scores (p = 0.003). Satisfaction was higher in all subgroups, though some lacked statistical significance due to sample size.
Conclusion: Meshed skin grafts were more effective than sheet grafts in scrotal reconstruction following Fournier’s gangrene, demonstrating superior aesthetic outcomes, greater patient satisfaction, and similar complication rates. Stratified analysis revealed consistently higher satisfaction across all subgroups with meshed grafts, although statistical significance was limited, likely due to the small sample size.
Key Words: Fournier Gangrene, Skin Transplantation, Scrotum, Surgery, Mesh Graft, Sheet Graft, Reconstructive Surgical Procedures.