Burbige K A, Hensle T W, Edgerton P
J Urol. 1984 Jun;131(6):1137-9. doi: 10.1016/s0022-5347(17)50845-9.
The reconstructive surgeon often is called upon to correct a severe deformity after previous operative attempts have failed, leaving a scarred and ischemic surgical field. A successful result requires an innovative operative approach and thorough knowledge of the established principles, as well as willingness to apply and to modify them. Frequently, one is faced with the so-called hypospadias crippled in whom little acceptable genital skin is available for urethral and penile reconstruction. When a salvage procedure is necessary in these instances we have used a free split thickness graft of extragenital skin. This technique was used in 11 male patients between 8 and 21 years old, the majority of whom were seen after multiple failed hypospadias or epispadias repairs. Complications included urethral stricture in 2 boys and fistula in 2 others. Long-term results have been excellent with a followup of 4 years. Although this procedure has not been accepted widely in the past, we believe that it can be useful if several important technical points are observed. This method is a useful addition in a salvage situation for urethral reconstruction when local skin is not available.
在前次手术尝试失败，留下瘢痕形成且血供不良的手术区域后，整形重建外科医生常常需要矫正严重畸形。成功的结果需要创新的手术方法、对既定原则的透彻了解，以及应用和修改这些原则的意愿。通常，人们会遇到所谓的重度尿道下裂患者，可供尿道和阴茎重建的合适生殖器官皮肤很少。在这些情况下需要进行挽救手术时，我们采用了取自生殖器官以外部位的游离薄断层皮片。该技术用于11例8至21岁的男性患者，他们大多数是在多次尿道下裂或尿道上裂修复失败后前来就诊的。并发症包括2名男孩出现尿道狭窄，另外2名出现瘘管。随访4年的长期结果非常理想。尽管过去这种手术方法尚未被广泛接受，但我们认为，如果注意几个重要的技术要点，它可能会有用。当无法获得局部皮肤时，这种方法在挽救性尿道重建中是一种有用的补充。
