Abaci Malik, Baran Özer
Training and Research Hospital of Karabük University, Karabük Merkez/Karabük, Turkey.
J Cutan Aesthet Surg. 2022 Oct-Dec;15(4):400-404. doi: 10.4103/JCAS.JCAS_233_20.
Due to its unique cosmetic appearance and functioning, scrotal skin offers a major clinical challenge in terms of reconstruction. Thus, successful reconstruction of scrotal skin should include both provision of pliable texture and protection of testicular functions. Skin grafts and flaps are important options for such reconstruction; however, they both have unique features that bring about specific limitations and specific problems.
In the light of the negativities related to the widely used skin grafts and flaps, this study aims to discuss the use of bilobed pudendal flap-a simple, uniform, and pliable tissue-for the first time in the related literature for the reconstruction of scrotal skin defects caused by Fournier's gangrene.
This study was performed using the single-step method of scrotal skin reconstruction on eight patients who had developed scrotal skin defects and underwent reconstruction by using three-dimensional bilobed pudendal flaps (defect and reconstructive tissues planned on different planes) from December 2016 to August 2019.
No complication such as infection, bleeding, hematoma, partial or complete flap loss, scar contraction, urinary problem, erectile dysfunction or discomfort, or sensation loss was observed in seven out of eight study patients. The only complication to have developed in one patient was minimal dehiscence, which was then corrected by restoration.
Repair of scrotal skin defect using a three-dimensional bilobed pudendal flap enabled an elastic scrotal repair acceptable in sensorial and visual terms.
由于阴囊皮肤独特的外观和功能,其重建在临床上是一项重大挑战。因此,成功的阴囊皮肤重建应既提供柔韧的质地又保护睾丸功能。皮肤移植和皮瓣是此类重建的重要选择;然而,它们都有独特的特点,带来特定的局限性和特定问题。
鉴于与广泛使用的皮肤移植和皮瓣相关的负面情况,本研究旨在首次在相关文献中探讨使用双叶会阴部皮瓣——一种简单、均匀且柔韧的组织——来重建由福尼尔坏疽引起的阴囊皮肤缺损。
本研究采用单步阴囊皮肤重建方法,对2016年12月至2019年8月期间出现阴囊皮肤缺损并使用三维双叶会阴部皮瓣(在不同平面规划缺损和重建组织)进行重建的8例患者进行研究。
8例研究患者中有7例未观察到感染、出血、血肿、部分或完全皮瓣丢失、瘢痕挛缩、泌尿问题、勃起功能障碍或不适、感觉丧失等并发症。1例患者出现的唯一并发症是轻微裂开,随后通过修复得到纠正。
使用三维双叶会阴部皮瓣修复阴囊皮肤缺损可实现感官和视觉上均可接受的弹性阴囊修复。