Fig. 1

Representative case of a penoscrotal injury where successful surgical reconstruction was achieved. a The 36-year-old male pedestrian with no underlying conditions was hit by a vehicle and admitted for soft tissue injury involving the scrotum and thigh, an ankle fracture, and a pelvic bone fracture. He was transfused for massive blood loss, but not intubated. The urologist confirmed that the wound did not invade the testicles and he had no problems with sexual function and urination. b After several debridements, he underwent a split-thickness skin graft. c One year later, he had discomfort due to scar contracture in his inguinal area, and the scar contracture was released with a Z-plasty. According to the five-category algorithm, he had orthopedic injury, required restraint, and transfusion—a total of three factors that could signify an advanced wound