Adamyan Ruben T, Kamalov Armais A, Ehoyan Misak M, Starceva Olesya I, Urshevich Eduard N, Sinelnikov Mikhail Y
Department of Plastic and Reconstructive Surgery, Petrovsky National Research Centre of Surgery, Moscow, Russian Federation.
Department of Oncology, Radiotherapy and Plastic Surgery, Sechenov University, Moscow, Russian Federation.
Plast Reconstr Surg Glob Open. 2020 Jul 24;8(7):e2948. doi: 10.1097/GOX.0000000000002948. eCollection 2020 Jul.
Correction of male urogenital pathology of different severity is complicated by the anatomical aspects of the penis. Skin texture, internal structures, and perfusion dynamics of the urogenital area make it a difficult area to reconstruct. We provide our experience with axial scrotal flaps for correction of penile defects of different severity and believe that these local flaps offer sufficient tissue characteristics for proper restoration of this complex region.
Forty-eight patients were divided into 3 groups depending on penile defect genesis and severity. Axial scrotal flap reconstruction was used for the correction of defects in all cases, when necessary in combination with other flaps.
Axial scrotal flaps for total and subtotal penile reconstruction serve as valuable material for reconstruction of the urogenital area, and are to be combined with other flaps for restoration of bulk tissues. Localized defects of the penis and urethra reconstructed by axial scrotal flaps provide excellent aesthetic results with minimal scaring, stable perfusion dynamics, and high satisfaction rate.
Scrotal tissues provide an excellent reconstruction material for penile defects because of their highly similar tissue structure as that of the penis. Scrotal axial flaps do not provide excess bulking in the postoperative period and are recommended for reconstruction of urethral and localized penile defects. Multistage surgery is recommended in cases of severe tissue damage, in combination with other flaps (inguinal, thoracodorsal, and radial).
阴茎的解剖结构使不同严重程度男性泌尿生殖系统病理状况的矫正变得复杂。泌尿生殖区域的皮肤质地、内部结构和灌注动力学使其成为一个难以重建的区域。我们分享了使用阴囊轴型皮瓣矫正不同严重程度阴茎缺损的经验,并认为这些局部皮瓣为该复杂区域的适当修复提供了足够的组织特性。
48例患者根据阴茎缺损的成因和严重程度分为3组。所有病例均采用阴囊轴型皮瓣重建矫正缺损,必要时与其他皮瓣联合使用。
用于阴茎全段和次全段重建的阴囊轴型皮瓣是泌尿生殖区域重建的宝贵材料,需与其他皮瓣联合使用以恢复组织量。通过阴囊轴型皮瓣重建阴茎和尿道的局部缺损,可获得极佳的美学效果,瘢痕最小,灌注动力学稳定,满意度高。
阴囊组织因其组织结构与阴茎高度相似,是阴茎缺损的优良重建材料。阴囊轴型皮瓣术后不会造成过多组织臃肿,推荐用于尿道和阴茎局部缺损的重建。对于严重组织损伤的病例,建议采用多阶段手术,并与其他皮瓣(腹股沟、胸背和桡侧)联合使用。