Scrotal and Perineal Reconstruction

Tran, Nho V.

doi:10.1055/s-0031-1281491

Cited by 22 publications

(29 citation statements)

References 33 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…After complete excision of the lesions, the resulting penile 56cm 2 (8 × 7 cm), scrotal 35-cm 2 (5 × 7 cm), and pubic-region 180-cm 2 (18 × 10 cm) defects were reconstructed by an STSG, scrotal flap, and pedicled ALT flap, respectively (Figs. 1,2). At the 31-month follow-up visit, local recurrence of EMPD was not seen, and the aesthetic result was acceptable ( Fig.…”

Section: Casementioning

confidence: 96%

Reconstruction Using Local Flaps for Penoscrotal Defects after Ablation of Skin Lesions

Kyung

Kwon

Song

et al. 2018

J Wound Management Res

View full text Add to dashboard Cite

Penoscrotal defects are associated with a variety of conditions, including extramammary Paget disease (EMPD), Fournier's gangrene (FG), and skin cancer. Careful reconstruction of the penoscrotal region is vital for sexual and urological functions [1]. The aims of reconstruction are to assist wound healing and provide adequate function and acceptable appearance. However, reconstruction of penoscrotal defects is difficult because of the variety of skin colors and thicknesses, the presence of bacterial flora, difficulty in immobilization, and complicated contours [1]. Therefore, a variety of approaches must be used for reconstruction, which are based on the size, position, and severity of the defect and the availability of surrounding tissue.We reconstructed penoscrotal defects using local advancement scrotal flaps, skin grafting, anterolateral thigh (ALT) flaps, and internal pudendal artery perforator (IPAP) flaps and obtained satisfactory results. The purpose of the study was to review and analyze the results of our patients who underwent reconstruction of penile and scrotal defects. AbstractBackground: Penoscrotal defects are associated with a variety of conditions, including extramammary Paget disease, Fournier's gangrene, and skin cancer. Careful reconstruction of the penoscrotal region is vital for sexual and urological functions. We used a variety of methods to reconstruct penoscrotal defects and obtained satisfactory results. Methods: We performed a retrospective chart review of 13 patients who underwent penoscrotal reconstruction from January 2012 to May 2016. All patients underwent radical debridement. The defect sizes ranged from 4 to 225 cm 2 (mean 75.0 cm 2 ). The reconstructive procedures were performed using split-thickness skin grafts (STSGs) and scrotal advancement, pedicled anterolateral thigh (ALT), and internal pudendal artery perforator (IPAP) flaps. Results: All of the flaps survived, with no reports of total flap necrosis or congestion. The overall surgical complication rate was 23.1%. A hematoma occurred in 1 patient and wound dehiscence occurred in 2 patients; the problems resolved after a minor surgical procedure. Conclusion: The selection of an appropriate reconstruction method should be based on the size, location, and severity of the defect in addition to the availability of local tissue. A skin graft is recommended for defects of the penile shaft. A scrotal flap is appropriate for the reconstruction of small scrotal defects, whereas the pedicled ALT flap and IPAP flap are recommended for large defects. We have proposed a flowchart for the reconstruction of penoscrotal defects that is based on the characteristics of the defects and our clinical experience.

show abstract

Section: Casementioning

confidence: 96%

Reconstruction Using Local Flaps for Penoscrotal Defects after Ablation of Skin Lesions

Kyung

Kwon

Song

et al. 2018

J Wound Management Res

View full text Add to dashboard Cite

show abstract

“…Several surgical methods, including the use of skin grafts, local flaps (fasciocutaneous flaps and musculocutaneous flaps), tissue expanders, and free flaps have been used for the reconstruction of penoscrotal defects (Ahn et al, 2014;Chen, Fu, Chen, & Chen, 2011;Chen, Fu, Wang, Lee, & Chen, 2010;Han et al, 2016Han et al, , 2018Kolehmainen, Suominen, & Tukiainen, 2013;Koo, Minn, & Chang, 2013;Lee et al, 2012;Maguiña, Palmieri, & Greenhalgh, 2003;Tran, 2011). However, thin skin grafts can lead to skin contracture and may interfere with the normal cremaster muscle reflex, eventually causing chronic pain.…”

Section: Discussionmentioning

confidence: 99%

Penoscrotal reconstruction with superficial circumflex iliac artery perforator propeller flap

2019

View full text Add to dashboard Cite

Background Successful penoscrotal reconstruction requires proper resurfacing of the defect and maintenance of the original shape of the penis and scrotum. We examined the feasibility of using the superficial circumflex iliac artery perforator (SCIP) propeller flap to effectively reconstruct penoscrotal defects. Methods Eleven male patients with an average age of 62.2 years were retrospectively evaluated. The average defect size was 21.3 × 10.5 cm2 (range: 10 × 8–24 × 16 cm2). An eccentrically located elliptical flap was constructed using a handheld Doppler device after detecting the perforator as the pivot point. The medial branch of the superficial circumflex iliac artery was used for all cases. Flaps were designed to cover 70–80% of the defect area and the average rotation arc was 165°. Results The average flap dimension was 19.7 × 7.7 cm2. Two cases showed partial necrosis in the flap tip area. There were no instances of total flap loss or lymphorrhea, or complications such as scar contracture, urination problems, erectile dysfunction, or discomfort during intercourse. Conclusions The SCIP flap is an effective and ideal method for penoscrotal reconstruction considering the loose, elastic, and thin nature of the tissue. Elevation is easily facilitated, and the thickness of the SCIP flap can be adjusted without microsurgery.

show abstract

“…It is also necessary to evacuate the large hematoceles to prevent possible ischemic damage by the compression both in cases with the presence and absence of testicular ruptures, as the lack of operative treatment (usually at least three days after the trauma) may later make it necessary to remove the testicle, with much greater percentages in relation to patients that have undergone an acute orchiectomy (1,(15)(16)(17)(18)(19).…”

Section: Discussionmentioning

confidence: 99%