ABSTRACT
<p><b>OBJECTIVE</b>To summarize the experience of repair and reconstruction of penile defects as a result of devastating deep burn.</p><p><b>METHODS</b>Twenty-four patients with penile defects in early or late (a half year after wound healed, the same below) stage after burn were involved. Their suspensory ligaments of penis were dissected to lengthen the penis after escharotomy with the necrotic distal part removed. The wounds formed after lengthening were covered with lower abdominal skin flap, scrotal or internal pudendal artery flap. Ten patients underwent surgery within 30 days after burn; the other 14 patients underwent surgery in the late stage. The condition of flaps and complications after surgery were observed. The lengths of penis of patients in flaccid and erection state were measured before surgery and at follow-up period. The sensory function of penile skin, the erectile function of the penis, and sexual intercourse activity of patients were followed up.</p><p><b>RESULTS</b>All the flaps survived except two, in whom areas of 1.0 cm x 0.5 cm and 1.5 cm x 1.0 cm of necrosis at distal parts were found, and they healed after dressing changes. Patients were followed up for 2 to 5 years. The length of penis in flaccid state was (7.4 +/- 1.6) cm, which was (5.3 +/- 1.4) cm longer than that before surgery (P < 0.01). The length of penis in erection state was (9.7 +/- 1.2) cm. The sensory function of penis recovered gradually about half year after surgery with well preserved erectile function. Except one who did not try to have sexual intercourse again, all the other married patients and their spouses were satisfied or quite satisfied with sexual intercourse activity.</p><p><b>CONCLUSIONS</b>Penis elongation combined with skin flap grafting is a good method for the treatment of penile defects due to devastating deep burn. Suitable length and erectile function of penis can be preserved with this method.</p>
Subject(s)
Adolescent , Adult , Child , Humans , Male , Middle Aged , Young Adult , Burns , General Surgery , Graft Survival , Penis , Wounds and Injuries , Plastic Surgery Procedures , Methods , Skin Transplantation , Surgical FlapsABSTRACT
<p><b>OBJECTIVE</b>To explore a simply, effective dynamical method to correct late facial palsy.</p><p><b>METHODS</b>The method of suspending of M. temporalis, temporal fascia was reformed below: (1) To prolong flap of M. temporalis, temporal fascia by parietal periosteum. (2) To elevate the reversal level of compound flap. (3) To fill depressed temporal area by silica gel piece.</p><p><b>RESULTS</b>The compound flap is united structurally and long enough to transfer. Temporal defect is recontoured. And zygomatic area is no longer protruded.</p><p><b>CONCLUSIONS</b>The reformative method resists defect of the old one and obtains a dynamical result.</p>
Subject(s)
Adult , Female , Humans , Male , Young Adult , Facial Paralysis , General Surgery , Fascia , Transplantation , Skull , Transplantation , Surgical Flaps , Temporal Muscle , TransplantationABSTRACT
<p><b>OBJECTIVE</b>To explore the effects of the combined method of abdominal axial flap transposition and penile elongation for the treatment of the remnant penis.</p><p><b>METHODS</b>Fifty-two cases of the remnant penis treated with the combined method from 1984 April to February 2004 were analyzed retrospectively. Follow-up ranged from 0.5 to 20 years postoperatively.</p><p><b>RESULTS</b>The lengths (both in normal and erectile conditions) and the circumferences of the penis gained after operation were (5.6 +/- 1.4) cm, (6.8 +/- 2.5 cm and (6.9 +/- 2.3) cm respectively. The recovery rates of the sensory function were 94.2% and 100% in the glans (immediately and 3 months after operation) and 32.7%, 51.9% and 75% in the flap area (3, 6 and 12 months postoperatively). The two-point distinguishing sense in the glans and the flap area was (5.1 +/- 0.9) mm and(7.9 +/- 1.3) mm 5 years after operation. Early complications included distant flap necrosis (3 cases), disruption of the wound (2 cases), part necrosis of the skin graft in the abdominal wall (2 cases) and poor contours occurred in 4 cases in the later period because of the thickness of the flaps. All of them were corrected with satisfactory results.</p><p><b>CONCLUSION</b>The combined method of abdominal axial flap transposition and penile elongation was recommendable for the treatment of the remnant penis because of its positive effects and less complications.</p>