Alwaal Amjad, McAninch Jack W, Harris Catherine R, Breyer Benjamin N
Department of Urology, University of California San Francisco, San Francisco, CA; Department of Urology, King Abdul Aziz University, Jeddah, Saudi Arabia.
Department of Urology, University of California San Francisco, San Francisco, CA.
Urology. 2015 Oct;86(4):835-9. doi: 10.1016/j.urology.2015.07.005. Epub 2015 Jul 16.
To report our successful outcomes of genital split-thickness skin graft (STSG) in covering major skin loss and providing good functional and cosmetic outcomes.
A retrospective chart review was performed for all adult urology patients who underwent STSG at our institution from 1998 to 2014. Patients had a wide range of disease etiologies, including tissue loss (eg post-Fournier's gangrene), lymphedema, buried penis, foreign body injection, and tumors.
A total of 54 patients were identified with the following breakdown of etiology: 13 patients with tissue loss (eg post-Fournier's gangrene), 13 with lymphedema, 12 with buried penis, 8 with foreign body injection, 4 with hidradenitis suppurativa, and 4 with tumors. Fifty-two out of 54 patients had more than 90% graft take, with maintained or improved erection, normal voiding, good cosmetic outcome as judged by the patient and the examining surgeon, and normal mobility. One patient died at 3 months due to cardiovascular cause, and 1 patient had a poor take of the graft.
We show the wide variety of indications for STSG use, the ease of the technique, and its successful outcomes. We believe this procedure should be offered to patients as a first-line treatment and also as a last resort when other more conservative approaches fail.
报告我们应用生殖器中厚皮片移植(STSG)成功覆盖大面积皮肤缺损并取得良好功能和美容效果的情况。
对1998年至2014年在我院接受STSG的所有成年泌尿外科患者进行回顾性病历审查。患者病因广泛,包括组织缺损(如福尼尔坏疽术后)、淋巴水肿、埋藏阴茎、异物注射和肿瘤等。
共确定54例患者,病因分布如下:13例组织缺损(如福尼尔坏疽术后),13例淋巴水肿,12例埋藏阴茎,8例异物注射,4例化脓性汗腺炎,4例肿瘤。54例患者中有52例移植皮片成活率超过90%,勃起功能得以维持或改善,排尿正常,患者及检查医生均认为美容效果良好,活动能力正常。1例患者在3个月时因心血管原因死亡,1例患者移植皮片成活率低。
我们展示了STSG应用的广泛适应证、技术的简便性及其成功效果。我们认为该手术应作为一线治疗方法提供给患者,在其他更保守方法失败时也可作为最后手段。