Pediatric penile reconstruction using autologous split-thickness skin graft.
Identifieur interne : 000841 ( PubMed/Corpus ); précédent : 000840; suivant : 000842Pediatric penile reconstruction using autologous split-thickness skin graft.
Auteurs : E C Diaz ; J F Corcoran ; E K JohnsonSource :
- Journal of pediatric urology [ 1873-4898 ] ; 2016.
English descriptors
- KwdEn :
- MESH :
- injuries : Penis.
- methods : Reconstructive Surgical Procedures, Urologic Surgical Procedures, Male.
- surgery : Penis.
- Child, Preschool, Humans, Male, Skin Transplantation.
Abstract
This video provides a case report of penis entrapment secondary to excessive skin removal during circumcision. It highlights the technical aspects of pediatric penile reconstruction using autologous split-thickness skin graft (STSG). Key points include: 1. Infection prevention is paramount and antibiotic prophylaxis is routine. 2. The usual harvest site for the STSG is the lateral thigh because of its source of glabrous skin and convenient proximity to the penis. The lateral thigh is also outside of the diapered area, which helps lessen postoperative pain and infectious risks. 3. A dermatome is used to harvest the STSG. Skin thickness for penis coverage at this age is usually 10-12/1000 of an inch. 4. Direct contact of the graft and wound bed is essential for graft uptake. Hemostasis of the wound bed is critical to prevent hematoma formation. Elimination of redundant tissue is also important to ensure maximal contact between the graft and underlying wound bed. 5. A pressure dressing or bolster is used to prevent shear, and provide contact between the graft and wound bed for at least the first 5 days. 6. A semi-occlusive dressing, Tegaderm, was used on the donor site and it is believed that it provides a moist environment conducive for epithelial and dermal healing. 7. Lymphedema can result if excess distal penile skin is not excised. It is prudent to limit the amount of mucosal collar or consider direct anastomosis to the glans.
DOI: 10.1016/j.jpurol.2016.02.022
PubMed: 27155806
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pubmed:27155806Le document en format XML
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<author><name sortKey="Diaz, E C" sort="Diaz, E C" uniqKey="Diaz E" first="E C" last="Diaz">E C Diaz</name>
<affiliation><nlm:affiliation>Department of Urology, Stanford University Medical Center, 300 Pasteur Drive, Room S-287, Stanford, CA 94305, USA. Electronic address: ecdiaz@stanford.edu.</nlm:affiliation>
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<author><name sortKey="Corcoran, J F" sort="Corcoran, J F" uniqKey="Corcoran J" first="J F" last="Corcoran">J F Corcoran</name>
<affiliation><nlm:affiliation>Division of Plastic Surgery, Ann and Robert H. Lurie Children's Hospital of Chicago, Northwestern University Feinberg School of Medicine, 225 E Chicago Avenue, Box 93, Chicago, IL 60611, USA.</nlm:affiliation>
</affiliation>
</author>
<author><name sortKey="Johnson, E K" sort="Johnson, E K" uniqKey="Johnson E" first="E K" last="Johnson">E K Johnson</name>
<affiliation><nlm:affiliation>Division of Pediatric Urology, Ann and Robert H. Lurie Children's Hospital of Chicago, Northwestern University Feinberg School of Medicine, 225 East Chicago Avenue, Box 24, Chicago, IL 60611, USA.</nlm:affiliation>
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<author><name sortKey="Diaz, E C" sort="Diaz, E C" uniqKey="Diaz E" first="E C" last="Diaz">E C Diaz</name>
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<affiliation><nlm:affiliation>Division of Plastic Surgery, Ann and Robert H. Lurie Children's Hospital of Chicago, Northwestern University Feinberg School of Medicine, 225 E Chicago Avenue, Box 93, Chicago, IL 60611, USA.</nlm:affiliation>
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<profileDesc><textClass><keywords scheme="KwdEn" xml:lang="en"><term>Child, Preschool</term>
<term>Humans</term>
<term>Male</term>
<term>Penis (injuries)</term>
<term>Penis (surgery)</term>
<term>Reconstructive Surgical Procedures (methods)</term>
<term>Skin Transplantation</term>
<term>Urologic Surgical Procedures, Male (methods)</term>
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<front><div type="abstract" xml:lang="en">This video provides a case report of penis entrapment secondary to excessive skin removal during circumcision. It highlights the technical aspects of pediatric penile reconstruction using autologous split-thickness skin graft (STSG). Key points include: 1. Infection prevention is paramount and antibiotic prophylaxis is routine. 2. The usual harvest site for the STSG is the lateral thigh because of its source of glabrous skin and convenient proximity to the penis. The lateral thigh is also outside of the diapered area, which helps lessen postoperative pain and infectious risks. 3. A dermatome is used to harvest the STSG. Skin thickness for penis coverage at this age is usually 10-12/1000 of an inch. 4. Direct contact of the graft and wound bed is essential for graft uptake. Hemostasis of the wound bed is critical to prevent hematoma formation. Elimination of redundant tissue is also important to ensure maximal contact between the graft and underlying wound bed. 5. A pressure dressing or bolster is used to prevent shear, and provide contact between the graft and wound bed for at least the first 5 days. 6. A semi-occlusive dressing, Tegaderm, was used on the donor site and it is believed that it provides a moist environment conducive for epithelial and dermal healing. 7. Lymphedema can result if excess distal penile skin is not excised. It is prudent to limit the amount of mucosal collar or consider direct anastomosis to the glans.</div>
</front>
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<Title>Journal of pediatric urology</Title>
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<Abstract><AbstractText>This video provides a case report of penis entrapment secondary to excessive skin removal during circumcision. It highlights the technical aspects of pediatric penile reconstruction using autologous split-thickness skin graft (STSG). Key points include: 1. Infection prevention is paramount and antibiotic prophylaxis is routine. 2. The usual harvest site for the STSG is the lateral thigh because of its source of glabrous skin and convenient proximity to the penis. The lateral thigh is also outside of the diapered area, which helps lessen postoperative pain and infectious risks. 3. A dermatome is used to harvest the STSG. Skin thickness for penis coverage at this age is usually 10-12/1000 of an inch. 4. Direct contact of the graft and wound bed is essential for graft uptake. Hemostasis of the wound bed is critical to prevent hematoma formation. Elimination of redundant tissue is also important to ensure maximal contact between the graft and underlying wound bed. 5. A pressure dressing or bolster is used to prevent shear, and provide contact between the graft and wound bed for at least the first 5 days. 6. A semi-occlusive dressing, Tegaderm, was used on the donor site and it is believed that it provides a moist environment conducive for epithelial and dermal healing. 7. Lymphedema can result if excess distal penile skin is not excised. It is prudent to limit the amount of mucosal collar or consider direct anastomosis to the glans.</AbstractText>
<CopyrightInformation>Copyright © 2016 Journal of Pediatric Urology Company. Published by Elsevier Ltd. All rights reserved.</CopyrightInformation>
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