Penile Reconstruction with the Radial Forearm Flap: An Update

Doornaert, Maarten; Hoebeke, Piet; Ceulemans, Peter; T’Sjoen, Guy; Heylens, Gunter; Monstrey, Stan

doi:10.1055/s-0030-1267215

Cited by 113 publications

(80 citation statements)

References 26 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…[23] published the largest series of 316 radial forearm phalloplasties performed by a single surgical team. They describe this as a very reliable technique for the creation of a normal looking penis and scrotum.…”

Section: Phalloplasty Techniquesmentioning

confidence: 99%

See 1 more Smart Citation

Phalloplasty: The dream and the reality

Rashid

Tamimy

2013

Indian J Plast Surg

View full text Add to dashboard Cite

Phalloplasty has come a long way as Plastic Surgery has evolved over the years. The complication ridden multistage tube pedicles popularized by Gillis were, with the advent of microsurgery, replaced by radial forearm flaps. The composite osteo-cutaneous version of this flap promised ‘All for one and one for all’ assuring both a reliable urinary conduit and a phallus stiffener. Prelamination and prefabrication to make the neo-urethra came with the promise of reducing both fistula and strictures but that did not happen and flap failure rates increased. Penile stiffeners of various types have been introduced; the artificial ones were associated with high infection and failure rates and are best inserted after the neo-penis regains some sensitivity. With the introduction of perforator flaps the Anterolateral thigh flap in its sensate pedicled form has started replacing the Radial forearm free flap as the first choice flap because of a hidden donor area and lack of microsurgical expertise requirement. Being sensate it tolerates a stiffener better. It is now possible to reconstruct an aesthetically pleasing glans as well, thus meeting both the aesthetic and functional desires of the patient. Complications encountered in this reconstructive effort include flap failure, urethral fistula, urethral stricture and stiffener related problems.

show abstract

Section: Phalloplasty Techniquesmentioning

confidence: 99%

“…The radial forearm, lateral arm and the Latissimus dorsi flap have the highest reported rates of survival among the most commonly performed free flaps. [234147] Total and partial flap failure rates are more commonly seen in OCFF as compared with other flaps. [2728446162]…”

Section: Complicationsmentioning

confidence: 99%

Phalloplasty: The dream and the reality

Rashid

Tamimy

2013

Indian J Plast Surg

View full text Add to dashboard Cite

show abstract

“…In practice, free flaps are rarely required for perineal reconstruction but may be used for special circumstances such as penile reconstruction with the radial forearm flap. 30 …”

Section: Free Flapsmentioning

confidence: 99%

Reconstruction of perineal defects

Mughal

Muneer

et al. 2013

annals

View full text Add to dashboard Cite

Introduction Perineal defects are commonly encountered in an oncological setting although they may also present as a result of trauma and infection (eg following Fournier’s gangrene). Reconstruction of these poses functional as well as aesthetic challenges. Skin coverage and tissue volume may both be required in addition to anogenital preservation or reconstruction. General prerequisites of an adequate reconstruction of perineal defects include provision of skin cover, well vascularised tissue to fill the dead space (reducing fluid collection and infection), vulvovaginal reconstruction and no faecal or urinary contamination. Methods A literature search was performed using PubMed and MEDLINE®. The search terms included ‘perineal defects’, ‘perineal reconstruction’, ‘perforator flaps for perineum’, ‘vulval flaps’, ‘secondary healing of wound’ and ‘vacuum assisted closure’. Backward chaining of reference lists from retrieved papers was also used to expand the search. Findings Modern developments have led to an increased expectation in improved quality of life as the main goal of reconstruction, therefore necessitating surgery with less morbidity and early return to normal activity. Progress in microsurgical procedures has been the main recent advance in perineal reconstruction and, in future, refinements in perforator flap design and tissue engineering techniques will lead to even better reconstructions.

show abstract

“…25 Although no controlled prospective randomized studies are available to confirm that the radial artery free flap phalloplasty (RAFF) is the best technique available, most authors consider that it is extremely reliable and yields excellent cosmetic and functional results in very experienced hands. [26][27][28][29][30][31][32][33] This procedure involves the creation of 'a tube within a tube' using forearm skin with the urethra fashioned from the non-hair bearing area and the whole flap based on the radial artery. Sensation is maintained due to the coaptation of the antebrachial nerves to the dorsal nerve of the penis in the male or of the clitoris in the female to male transsexual and to the iliohypogastric and ilioinguinal nerves.…”

Section: Table 1 Surgical Procedures Involving Partial or Complete Exmentioning

confidence: 99%