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MESHED UNEXPANDED SPLIT-THICKNESS SKIN GRAFTING FOR RECONSTRUCTION OF PENILE SKIN LOSS

2004; Lippincott Williams & Wilkins; Volume: 172; Issue: 3 Linguagem: Inglês

10.1097/01.ju.0000133972.65501.44

1527-3792

Peter C. Black, Jeffrey B. Friedrich, Loren H. Engrav, Hunter Wessells,

Urologic and reproductive health conditions

No AccessJournal of UrologyAdult Urology: Trauma/Reconstruction/Diversion1 Sep 2004MESHED UNEXPANDED SPLIT-THICKNESS SKIN GRAFTING FOR RECONSTRUCTION OF PENILE SKIN LOSS PETER C. BLACK, JEFFREY B. FRIEDRICH, LOREN H. ENGRAV, and HUNTER WESSELLS PETER C. BLACKPETER C. BLACK , JEFFREY B. FRIEDRICHJEFFREY B. FRIEDRICH , LOREN H. ENGRAVLOREN H. ENGRAV , and HUNTER WESSELLSHUNTER WESSELLS View All Author Informationhttps://doi.org/10.1097/01.ju.0000133972.65501.44AboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract Purpose: Sheets of unmeshed, split-thickness skin grafts (STSGs) have been advocated in potent men with penile skin deficiency. Since the survival of sheet grafts is rarely 100% and the appearance of unexpanded 1:1 mesh grafts is quite good, we used this technique. We report our experience with meshed, unexpanded STSGs for all penile resurfacing regardless of erectile function. Materials and Methods: Nine consecutive patients with penile skin loss were prospectively treated between March 2001 and January 2003 with meshed STSGs to the penis. The underlying condition was Fournier's gangrene in 4 cases, chronic lymphedema in 2, skin deficiency from prior surgeries in 2 and Crohn's disease in 1. Graft thickness was 0.012 or 0.016 inches and meshing was performed in a 1:1 ratio. Meshed slits were oriented transversely without expansion and the graft juncture was located on the ventral surface in zigzag fashion. Graft take, appearance, and sexual and voiding function were assessed postoperatively. Results: All 9 patients had 100% graft take. At a mean followup of 6 months a satisfactory cosmetic outcome was documented photographically in all except 1 case involving chronic penile manipulation. Erectile function and ejaculation were preserved in potent patients. Conclusions: Unexpanded meshed STSGs of penile skin loss yielded satisfactory functional and cosmetic outcomes. References 1 : Fournier's gangrene: a review of 1726 cases. Br J Surg2000; 87: 718. Google Scholar 2 : Major traumatic and septic genital injuries. J Trauma1984; 24: 291. Google Scholar 3 : Management of genital skin loss. Urol Clin North Am1989; 16: 387. Google Scholar 4 : Elephantiasis of the penis and scrotum. A review of 350 cases. Am J Surg1985; 149: 686. Google Scholar 5 : Surgical reconstruction of the sequelae of penile and scrotal gangrene: a plea for simplicity. Br J Plast Surg1984; 37: 354. Google Scholar 6 : Traumatic avulsion of scrotum and penile skin. Br J Plast Surg1967; 20: 97. Google Scholar 7 : Surgical reconstruction of the penis in skin losses, using scrotum skin. Br J Plast Surg1968; 21: 253. Google Scholar 8 : An evaluation of skin grafts for reconstruction of the penis and scrotum. Clin Plast Surg1988; 15: 411. Google Scholar 9 : Skin graft reconstruction of chronic genital lymphedema. Urology1997; 50: 423. Google Scholar 10 : Tissue transfer techniques for genitourinary reconstructive surgery. Part I—principles, definitions, basic techniques and graft techniques. AUA Update1988; vol. VII: 66. lesson 9. Google Scholar 11 : Free skin graft in the treatment of penile skin defects. Acta Chir Plast1981; 23: 235. Google Scholar 12 : Management of burns of the penis. J Burn Care Rehabil1993; 14: 525. Google Scholar 13 : Late results of split-grafted penoscrotal avulsion injuries. J Trauma1995; 39: 1201. Google Scholar 14 : A method for optimizing skin graft healing and outcome of wounds of the penile shaft and scrotum. Ann Plast Surg1993; 31: 447. Google Scholar 15 : Contraction rates of meshed, nonexpanded split-thickness skin grafts versus split-thickness sheet grafts. Ann Plast Surg1993; 31: 162. Google Scholar From the Department of Urology and Division of Plastic Surgery, Department of Surgery, Harborview Medical Center and University of Washington School of Medicine, Seattle, Washington© 2004 by American Urological Association, Inc.FiguresReferencesRelatedDetails Volume 172Issue 3September 2004Page: 976-979 Advertisement Copyright & Permissions© 2004 by American Urological Association, Inc.Keywordsfasciitis, necrotizingpenistreatment outcomeskin transplantationMetrics Author Information PETER C. BLACK More articles by this author JEFFREY B. FRIEDRICH More articles by this author LOREN H. ENGRAV More articles by this author HUNTER WESSELLS More articles by this author Expand All Advertisement PDF downloadLoading ...