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创伤后阴茎再植伴最小程度皮肤坏死

Posttraumatic Penile Replantation with Minimal Skin Necrosis.

作者信息

Veeramani Anamika, Hwang Charles D, Gardenier Jason C, Fruge Seth E, Khouri Kimberly S, Ehret Ashley L, Vieira Brittany L, Buta Martin R, Cetrulo Curtis L

机构信息

From the Division of Plastic and Reconstructive Surgery, Department of Surgery, Massachusetts General Hospital, Harvard University, Boston, Ma.

出版信息

Plast Reconstr Surg Glob Open. 2023 Aug 24;11(8):e5205. doi: 10.1097/GOX.0000000000005205. eCollection 2023 Aug.

Abstract

Penile amputation is a surgical emergency where practical and timely perioperative management is crucial for ensuring a successful outcome. Tenuous viability of penile and scrotal skin has been well described in the literature, with a putative mechanism attributed to the transection of distal branches of the external pudendal artery. Although the perforasomes critical to penile replantation have been debated, this case report details a patient who successfully recovered sensation and function with minimal necrosis after penile replantation. Surgically, this was facilitated by intentional drain placement, aggressive debridement beyond the zone of injury, and planned redundancies with dorsal artery/vein anastomoses via interposition grafts of the dorsal penile vessels alone.

摘要

阴茎离断是一种外科急症,切实及时的围手术期管理对于确保成功预后至关重要。阴茎和阴囊皮肤的微弱存活能力在文献中已有充分描述,一种假定机制认为是阴部外动脉远端分支被横断所致。尽管对于阴茎再植至关重要的穿支体存在争议,但本病例报告详细介绍了一名患者在阴茎再植后成功恢复感觉和功能且坏死极少的情况。在手术方面,通过有意放置引流管、对损伤区域以外进行积极清创以及仅通过阴茎背侧血管的间置移植对背侧动脉/静脉进行吻合时预留冗余部分,使得手术得以顺利进行。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/c2d1/10448931/e2493e9c7bcc/gox-11-e5205-g001.jpg

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