Perineal Reconstruction After Necrotizing Fasciitis: Surgical Techniques and Challenges

Introduction: Perineal reconstruction following necrotizing fasciitis presents unique challenges due to complex anatomy and contamination risk. Objective: To critically examine contemporary reconstructive strategies—including timing, techniques, functional outcomes, and adjunct modalities—for perineal defects secondary to necrotizing fasciitis. Methods: A narrative review of English‑language PubMed‑indexed studies from 2019–2025 covering surgical reconstruction, complications, and patient‑reported outcomes was performed. Results and Discussion: Skin grafts, local and regional flaps, free tissue transfers, and adjunctive therapies each demonstrate specific profiles in morbidity, healing time, and functional restoration. Conclusion: Individualized, multidisciplinary approaches considering defect characteristics, patient comorbidities, and functional priorities are essential.