Use of anterolateral thigh flap and split-thickness skin grafting for soft tissve defectionof massive penoscrotal Paget's disease / 中华泌尿外科杂志

ABSTRACT

Objective To evaluate the effectiveness of using the anterolateral thigh flap and splitthickness skin grafting to repair large skin defect secondary to the excision of massive penoscrotal Paget's disease.Methods Clinical data of 6 patients with massive penoscrotal Paget's disease were retrospectively reviewed.The patients were admitted to our institute from Feb.2005 to Oct.2010 with mean age of 64 (55-68) years.No other neoplasm and enlarged inguinal lymph node were detected on physical examination,ultrasonography and CT scan.All cases underwent wide local excision of skin lesion which was taken 2 cm beyond the boundary under epidural anesthesia.An anterolateral thigh flap was used to reconstruct the scrotum,and the skin defect of penis was repaired by split-thickness skin grafting.Results Operation was uneventful for the 6 patients,with mean skin defect of 185 (150-210) cm2.The mean operative duration was 270 (210-300) min,and the mean blood loss was 75 (35-150) ml.Negative surgical margins were confirmed on postoperative pathology.Five patients recovered smoothly with satisfying cosmetic appearance,and one patient demonstrated partial necrosis of the flap which was repaired on secondary surgery.The mean follow-up was 37 (10-60) months,and no relapse was found.Conclusions It is an effective method to use anterolateral thigh flap and split-thickness skin grafting to repair large skin defect secondary to excision of massive penoscrotal Paget's disease.