The surgical management of traumatic penoscrotal skin avulsion.
Yao, H1; Zheng, D1; Xie, M1; Jiang, Y1; Wang, Z1
1: Shanghai 9th People's Hospital ,Shanghai Jiao Tong University,School of Medicine, Shanghai, P.R. China
Objective: Management of traumatic skin avulsion in the penoscrotal region can be quite challenging.Lacation,size,shape,and orientation of the defects are important factors in determining the method used in reconsctruciont.
Material and Method: Retrospective cohort review was conducted for 36 patients with penoscrotal skin loss treated at Shanghai 9th People's Hospital, between January 2003 and November 2016.All patients were admitted under urological Surgery Department within this period with injury in the penoscrotal region were included in this study. A total of 36 patients were observed. Three different methods were used to repair the penoscrotal skin avulsion(including: primary suture, split skin graft and Pedicel flap ).
Result: Among the 36 patients, 35 cases were treated by emergency surgery, 1 case was delayed due to wound infection on admission, more than 90% of wounds were cured in 29 cases, 6 cases of wound healing in 70% , 1 case of postoperative wound infection and necrosis 2 times. The postoperative appearance of the penis scrotum was basically satisfactory, of which the most complete appearance of flap method, sexual function (IIEF score) and spermatogenic function with the smallest impact of the adjacent flaps.
Conclusion: The split skin graft has been found to be the most satisfactory method for cover penile skin loss.Scrotal skin avulsions require additional judgment for the treamt.Scrotal skin remnants must be used to cover whenever possible. Skin grafts have shown better fertility at the cost of tenderness.ALTP and Abdominal flaps may also be used for scrotal reconstruction.
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