Xie Wei-Guo, Long Dao-Chou, Zhu Hui, Yu Mo-Sheng, Wu Xiao-Wei, Yu Gang, Zhang Wei
Tongren Hospital of Wuhan University, Wuhan 430060, China.
Zhonghua Shao Shang Za Zhi. 2009 Dec;25(6):407-10.
To summarize the experience of repair and reconstruction of penile defects as a result of devastating deep burn.
Twenty-four patients with penile defects in early or late (a half year after wound healed, the same below) stage after burn were involved. Their suspensory ligaments of penis were dissected to lengthen the penis after escharotomy with the necrotic distal part removed. The wounds formed after lengthening were covered with lower abdominal skin flap, scrotal or internal pudendal artery flap. Ten patients underwent surgery within 30 days after burn; the other 14 patients underwent surgery in the late stage. The condition of flaps and complications after surgery were observed. The lengths of penis of patients in flaccid and erection state were measured before surgery and at follow-up period. The sensory function of penile skin, the erectile function of the penis, and sexual intercourse activity of patients were followed up.
All the flaps survived except two, in whom areas of 1.0 cm x 0.5 cm and 1.5 cm x 1.0 cm of necrosis at distal parts were found, and they healed after dressing changes. Patients were followed up for 2 to 5 years. The length of penis in flaccid state was (7.4 +/- 1.6) cm, which was (5.3 +/- 1.4) cm longer than that before surgery (P < 0.01). The length of penis in erection state was (9.7 +/- 1.2) cm. The sensory function of penis recovered gradually about half year after surgery with well preserved erectile function. Except one who did not try to have sexual intercourse again, all the other married patients and their spouses were satisfied or quite satisfied with sexual intercourse activity.
Penis elongation combined with skin flap grafting is a good method for the treatment of penile defects due to devastating deep burn. Suitable length and erectile function of penis can be preserved with this method.
总结严重深度烧伤致阴茎缺损的修复与重建经验。
纳入24例烧伤后早期或晚期（伤后半年，下同）阴茎缺损患者。切除坏死远端部分后行焦痂切开术，解剖阴茎悬韧带以延长阴茎。延长后形成的创面用下腹皮瓣、阴囊或阴部内动脉皮瓣覆盖。10例患者在烧伤后30天内接受手术；另外14例患者在晚期接受手术。观察术后皮瓣情况及并发症。测量术前及随访期间患者阴茎疲软和勃起状态下的长度。随访患者阴茎皮肤感觉功能、阴茎勃起功能及性交情况。
除2例皮瓣远端分别出现1.0 cm×0.5 cm和1.5 cm×1.0 cm坏死区，经换药后愈合外，其余皮瓣均存活。患者随访2至5年。阴茎疲软状态下长度为(7.4±1.6)cm，较术前延长(5.3±1.4)cm(P<0.01)。阴茎勃起状态下长度为(9.7±1.2)cm。术后约半年阴茎感觉功能逐渐恢复，勃起功能良好。除1例未再尝试性交外，其余已婚患者及其配偶对性交情况满意或较满意。
阴茎延长联合皮瓣移植是治疗严重深度烧伤致阴茎缺损的良好方法。该方法可保留合适的阴茎长度及勃起功能。
