阴囊前侧双蒂肉膜皮瓣移植覆盖在阴茎皮肤坏死早期处理中的应用  

Application of anterior scrotal double pedicle musculocutaneous flap transplantation in the early treatment of penile necrosis

作　　者：陈日娴 张吉[1] 蒋萱[1] 陈兵[1] 王晋煌[1] 陈伯华[1] 柳大烈[1] 杨晓[1] CHEN Ri-xian;ZHANG Ji;JIANG Xuan;CHEN Bing;Wang Jin-huang;CHEN Bo-hua;LIU Da-lie;YANG Xiao(Department of Plastic and Cosmetic Surgery,Zhujiang Hospital of Southern Medical University,Guangzhou 510282,China)

机构地区：[1]南方医科大学珠江医院整形美容外科,广东广州510282

出　　处：《中国美容整形外科杂志》2021年第7期407-410,共4页Chinese Journal of Aesthetic and Plastic Surgery

摘　　要：目的探索阴囊前侧双蒂肉膜皮瓣覆盖在阴茎坏死早期处理中的重要性。方法自2003—2019年,南方医科大学珠江医院整形美容外科共治疗了11例行包皮环切术后阴茎皮肤坏死缺损的患者,局部清创后即刻应用阴囊前侧双蒂肉膜皮瓣覆盖创面,供区直接缝合。结果11例患者术后均未出现皮瓣坏死。其中9例就诊及时,患者对治疗后阴茎外观恢复较满意;1例就诊时尿道海绵体已严重缺损,伴有尿管外露,采用阴囊皮瓣修复后仍遗留尿瘘,但患者对阴茎外观基本满意;1例就诊时阴茎体前2/3组织坏死,因缺损严重,采用阴囊皮瓣手术治疗2周后,阴茎头部出现坏死脱落,但残余阴茎体形态尚可。结论阴囊前侧双蒂肉膜皮瓣的血运及皮源丰富,色泽、质地与阴茎皮肤相近,修复阴茎皮肤缺损后的感觉和形状均良好,故应用于包皮环切术后阴茎皮肤坏死缺损的早期覆盖,可阻止创面的进一步恶化,挽救阴茎,提高患者的生活质量。Objective To explore the importance of anterior scrotal double pedicle musculocutaneous flap in the early treatment of penile necrosis.Methods From 2003 to 2019,a total of 11 patients with penile necrosis after posthetomy were admitted to Zhujiang Hospital of Southern Medical University.After local debridement,the anterior scrotal double pedicle musculocutaneous flap was applied to cover the wound immediately.The donor area was directly sutured.Results No flap necrosis occurred in 11 patients after operation.Nine patients were timely hospitalization and satisfied with the appearance of penises after treatment.Severe damage of urethra cavernous body accompanied by urinary tube exposure occurred in 1 patient at the time of admission.Although urinary fistula still left after scrotal flap repair,the patient was basically satisfied with the appearance of the penis.One patient had severe defects caused by necrosis of anterior two-thirds of the penis at the time of admission.At 2 weeks after scrotal flap treatment,necrosis and exfoliation appeared at the head of penis.The morphology of residual penis was acceptable.Conclusion The anterior scrotal double pedicle musculocutaneous flap has abundant blood supply and skin source.The color and texture was similar to the penile skin.The feeling and shape of penile skin after repair were good.The application of anterior scrotal double pedicle musculocutaneous flap in the early coverage of penile skin defects after posthetomy can prevent further deterioration of the wounds,save the penis and improve the life quality of patient.

关 键 词：阴茎皮肤缺损 阴囊前侧双蒂肉膜皮瓣 早期处理 创面修复 

分 类 号：R699.8[医药卫生—泌尿科学]