应用不同血管蒂阴囊皮瓣修复阴茎皮肤缺损  

Repair of penis skin defects with scrotal flaps pedicled with different vessels

作　　者：刘小容[1] 刘玉生[1] 陈可琼[1] 高雁[1] 黄伟龙[1] 黎德燕[1] 张晓玲[1] 

机构地区：[1]东莞市人民医院医学美容科,广东东莞523018

出　　处：《中国美容整形外科杂志》2011年第5期274-277,共4页Chinese Journal of Aesthetic and Plastic Surgery

摘　　要：目的 探讨应用两种带不同血管蒂的阴囊皮瓣修复阴茎皮肤缺损的方法及效果。方法对阴茎皮肤肿瘤患者，应用Mohs法切除病变组织，并对切除标本进行快速冰冻切片，直至切除干净，最大限度地保留阴茎的正常组织；对感染者于Buck’S筋膜浅面将肉芽组织完整切除。根据阴茎皮肤缺损的大小设计大于缺损面积10％的皮瓣。自2003年8月至2010年6月，应用带血管蒂阴囊皮瓣修复阴茎皮肤缺损共13例，其中8例应用阴囊前动静脉蒂皮瓣修复，5例应用阴囊中隔血管蒂皮瓣修复。结果 1例阴囊前动静脉蒂皮瓣由于转移隧道过紧出现远端少许坏死，经换药后伤口愈合，其余皮瓣完全存活。所有患者随访3个月至2年，阴茎外形及功能恢复满意，阴囊无变形，供区瘢痕不明显。结论阴囊皮瓣薄，无皮下脂肪，具有伸展性，与阴茎皮肤类似；对阴茎皮肤部分或全部缺损者应用阴囊前动静脉蒂或阴囊中隔血管蒂的阴囊皮瓣修复，可获得阴茎外形及功能满意的修复效果。Objective To explore the methods and effects of skin defects of the penis repaired with two kinds of serotaI flaps pedicled with different vessels. Methods The penile skin neoplasm was resected by Mobs surgery and phallic normal tissue was reserved as possible as we could. The excised specimen was per- formed the rapid frozen section ; for the penile skin with infection, granulation tissue was cut completely on su- perficial layer of Buck＇s fascia. The flaps were designed over-sized by 10% according to the penile skin de- fects. From August 2003 to June 2010, the skin defects of the penis were repaired with the scrotal flaps pedi- cled with various vessels in 13 cases, including flaps pedieled with anterior scrotal vessels in 8 cases and pedi- cled with serotal septal vessels in 5 cases. Results All the flaps survived completely except one flap pedicled with anterior scrotal vessels was necrosis on remote end because of over-tight tunnel, which was healed by change dressings. Follow-up was performed for 3 to 24 months, the penis in all cases recovered with natural contour, good functions and concealed scar at the donor site. Conclusion The scrotal flap is similar to the pe- nile skin for fine skin quality, adequate skin flexibility and thin-thickness tissue without subcutaneous fat, therefore, the partial or complete skin defects of the penis should be resurfaced with the scrotal flap either pedi- eled with anterior scrotal vessels or pedieled with scrotal septal vessels.

关 键 词：血管蒂 阴囊皮瓣 阴茎 皮肤缺损 

分 类 号：R697.15[医药卫生—泌尿科学]