Lembo Fedele, Cecchino Liberato Roberto, Parisi Domenico, Portincasa Aurelio
Department of Plastic and Reconstructive Surgery, Ospedali Riuniti-University of Foggia, Foggia, Italy.
Urologia. 2022 Nov;89(4):623-628. doi: 10.1177/03915603211046164. Epub 2021 Sep 14.
Scrotal degloving injuries are rare and constitute a challenge for reconstructive surgeons. The authors describe their successful experience with a combined reconstruction protocol using an acellular dermal matrix (ADM), negative pressure wound therapy (NPWT) and a split-thickness skin graft (STSG), and the retrospective assessment of overall morbidity and esthetic outcomes.
Five consecutive patients underwent a wide excision of necrotic scrotal skin and a reconstruction procedure using a combined protocol with NPWT, Pelnac, and STSG. The efficacy of this treatment was determined by assessing overall morbidity and esthetic outcomes with the Vancouver Scar Scale (VSS).
The combined protocol made it possible to create an environment that promoted wound healing, improved graft intake, and gage the reconstructed site a more natural look. No significant problems were observed. Satisfactory cosmetic and functional results were obtained in all patients as shown by VSS scores obtained.
We believe that this combined protocol is a reliable alternative to flaps and should be considered an excellent option in scrotal reconstruction, especially in critical patients.
阴囊脱套伤较为罕见，给重建外科医生带来挑战。作者描述了他们使用脱细胞真皮基质（ADM）、负压伤口治疗（NPWT）和中厚皮片移植（STSG）联合重建方案的成功经验，以及对总体发病率和美学效果的回顾性评估。
连续5例患者接受了阴囊坏死皮肤的广泛切除，并采用NPWT、Pelnac和STSG联合方案进行重建手术。通过使用温哥华瘢痕量表（VSS）评估总体发病率和美学效果来确定该治疗方法的疗效。
联合方案能够营造促进伤口愈合的环境，提高移植成功率，并使重建部位外观更自然。未观察到明显问题。根据获得的VSS评分显示，所有患者均取得了满意的美容和功能效果。
我们认为，这种联合方案是皮瓣的可靠替代方案，在阴囊重建中应被视为一种极佳选择，尤其是对于病情危急的患者。
