Dong Wenfang, Xiao Xiaodi, Wang Zheng, Yang Xin, Bi Hongsen
Department of Plastic and Reconstructive Surgery, Peking University Third Hospital, Beijing, China.
Int J Dermatol. 2025 Jan;64(1):142-148. doi: 10.1111/ijd.17325. Epub 2024 Jul 15.
Extramammary Paget's disease (EMPD) is a rare intra-epidermal adenocarcinoma, and reconstruction of the penoscrotal region remains a clinical challenge. The superficial circumflex iliac artery perforator (SCIP) flap has been successfully used as a free flap, while its application as a propeller flap in the reconstruction of penoscrotal EMPD defect is rarely reported. The objective was to evaluate the safety and efficacy of the SCIP propeller flap in the reconstruction of penoscrotal defects in EMPD.
Between September 2010 and August 2022, consecutive patients diagnosed with penoscrotal EMPD were enrolled. All patients underwent penoscrotal EMPD excision and reconstruction with SCIP propeller flap combined with other flaps or skin grafts on individual defects. Demographic information, surgical parameters, postoperative complications, patient satisfaction, and recurrence rates were analyzed.
Twenty-four patients (mean age, 73 ± 8.8 years; mean BMI, 23.98 ± 3.62 kg/m) with 33 SCIP propeller flaps (mean size 120.1 cm; range, 24-208 cm) were included, and the mean defect size was 67.4 cm (range, 12-255 cm). The mean operative duration was 385.4 ± 146.8 min. Fifteen patients received autologous full-thickness skin grafts, and four received other flaps simultaneously. All flaps survived without total or partial loss, and all donor sites achieved primary closure, though local hematoma (one case) and limited skin graft necrosis (two cases) were observed. All patients experienced complete wound healing and maintained penoscrotal morphology and function without recurrent lesions over a mean follow-up of 59 months.
The SCIP propeller flap seems a safe and effective reconstructive method for penoscrotal EMPD.
IV.
乳房外佩吉特病（EMPD）是一种罕见的表皮内腺癌，阴茎阴囊区域的重建仍然是一项临床挑战。旋髂浅动脉穿支（SCIP）皮瓣已成功用作游离皮瓣，而其作为推进皮瓣在阴茎阴囊EMPD缺损重建中的应用鲜有报道。目的是评估SCIP推进皮瓣在阴茎阴囊EMPD缺损重建中的安全性和有效性。
2010年9月至2022年8月，纳入连续诊断为阴茎阴囊EMPD的患者。所有患者均接受阴茎阴囊EMPD切除，并根据个体缺损情况采用SCIP推进皮瓣联合其他皮瓣或植皮进行重建。分析人口统计学信息、手术参数、术后并发症、患者满意度和复发率。
纳入24例患者（平均年龄73±8.8岁；平均BMI 23.98±3.62kg/m），共使用33个SCIP推进皮瓣（平均大小120.1cm；范围24-208cm），平均缺损大小为67.4cm（范围12-255cm）。平均手术时间为385.4±146.8分钟。15例患者接受了自体全厚皮片移植，4例同时接受了其他皮瓣移植。所有皮瓣均存活，无全部或部分坏死，所有供区均实现一期闭合，尽管观察到1例局部血肿和2例局限性植皮坏死。所有患者伤口均完全愈合，阴茎阴囊形态和功能得以维持，平均随访59个月无复发病变。
SCIP推进皮瓣似乎是一种用于阴茎阴囊EMPD的安全有效的重建方法。
IV级。
