Zhang Siya, Zhou Chuande, Li Fengyong, Li Senkai, Zhou Yu, Li Qiang
10th Department, Plastic Surgery Hospital, Chinese Academy of Medical Sciences, Beijing, China.
Urol Int. 2016;96(3):255-9. doi: 10.1159/000444331. Epub 2016 Feb 20.
The study aims to report the method and outcome of using scrotal-septal fasciocutaneous flap as a multifunctional coverage for prior failed hypospadias repair.
From January 2014 to June 2015, 18 hypospadias patients who have undergone repeated failed surgeries were enrolled. Their penile skin, urethral plate and dartos fascia are not enough to reconstruct the urethra, but have well-developed scrota. We performed urethroplasty by buccal mucosa free grafting and tubularized anastomosis 6 months after the urethroplasty. Then, scrotal-septal fasciocutaneous flap was used to be a multifunctional coverage on the surface of anastomotic urethra, which was a waterproof layer and cutaneous coverage.
The skin flaps survived and the incisions healed in 18 patients. No fistula and stricture occurred. The scar of donor site seemed like a new scrotal raphe. The flap can slip slightly along with the preputial movement and retain the original sense of touch. All patients were followed up at 1 and 6 months by telephone or in person and gained good recoveries.
Scrotal-septal fasciocutaneous flap, including sufficient fascia tissue, reliable blood supply and skin coverage, is a good choice for the coverage of anastomotic urethra as both the waterproof layer and skin coverage, especially for hypospadias patients who have undergone several failed operations.
本研究旨在报告使用阴囊纵隔筋膜皮瓣作为多功能覆盖物用于既往尿道下裂修复失败的方法及结果。
2014年1月至2015年6月，纳入18例经历多次手术失败的尿道下裂患者。他们的阴茎皮肤、尿道板和肉膜筋膜不足以重建尿道，但阴囊发育良好。在尿道成形术后6个月，我们采用颊黏膜游离移植和管状吻合术进行尿道成形术。然后，使用阴囊纵隔筋膜皮瓣对吻合后的尿道表面进行多功能覆盖，起到防水层和皮肤覆盖的作用。
18例患者皮瓣存活，切口愈合。未发生瘘管和狭窄。供区瘢痕类似新的阴囊中缝。皮瓣可随包皮移动而轻微滑动，并保留原始触觉。所有患者在术后1个月和6个月通过电话或当面随访，恢复良好。
阴囊纵隔筋膜皮瓣包含足够的筋膜组织、可靠的血供和皮肤覆盖，是作为防水层和皮肤覆盖物覆盖吻合后尿道的良好选择，尤其适用于经历多次手术失败的尿道下裂患者。
