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Background A wide array of diseases can lead to skin defects of the male genitalia. Although reconstructive options have been debated in the literature, no study has compared the effectiveness of a meshed split-thickness skin graft (STSG) and a sheet STSG in perineal and scrotal wound coverage. In this study, we report our experience in a tertiary trauma center. Methodology In this retrospective study, we included cases with a skin defect of the male genitalia, for which genital reconstruction with a skin graft was performed at our hospital from December 2017 to February 2020. This study was approved by the institutional review board. The analysis was performed at 95% confidence interval using the Statistical Package for Social Science (SPSS) version 23.0 (IBM Corp., Armonk, NY, USA). Results A total of 27 patients were included in the study. The most common indication for genital reconstruction was Fournier's gangrene (59.3%). In 15 (55.6%) patients, a meshed skin graft was utilized to cover the defect, whereas a sheet graft was utilized in 12 (44.4%) patients. Out of the 15 patients who underwent genital reconstruction with a meshed graft, 10 (66.6%) had complete graft take. On the other hand, out of the 12 (44.4%) patients who underwent genital reconstruction using a sheet graft, five (41.6%) had complete graft take. A statistically significant relationship was found between aesthetic and functional outcomes and the type of skin graft used. The satisfaction rate was higher among meshed skin graft recipients (86.2%) compared to sheet skin graft recipients (41.7%) (p = 0.014). Conclusions Based on our observational experience, we found that meshed STSG to cover male genital skin defects is safe with satisfactory cosmetic outcomes. Further prospective randomized studies are needed.
RESUMO
Penile and scrotal skin degloving is uncommon and is mainly caused by accidents with agricultural and industrial machines. Such injuries are called "power take-off injuries," defined as injuries caused by power transmitted from one object to another. Penile injuries can be extremely disturbing to the physical and mental state of the patient, if not managed properly. We present the case of a 26-year-old man with traumatic degloving of penile and scrotal skin and exposed spongy body, cavernous bodies, and testicles caused by an accident on a farm tractor. The patient was presented to our emergency department 14 hours after his pants getting caught in the rotating driveshaft, which subsequently pulled him at the groin level, whereby the machine grasped the redundant skin of the penis and scrotum. The patient underwent single-stage surgical reconstruction using split-thickness skin graft 48 hours within initial presentation. Postoperative period was uneventful. He was discharged 6 days after operation. At the 8-week follow-up visit, he showed a satisfactory cosmetic outcome, well-healed scrotal and penile grafts, reestablished sexual function, and normal voiding.
RESUMO
BACKGROUND We assessed body composition, adiposity, cardiovascular risk, and cognitive functions in healthy young adult females and investigated the possible correlation between neurocognitive decline, adiposity, and cardiovascular risk markers. MATERIAL AND METHODS This cross-sectional study was conducted on 83 healthy, young adult, Saudi women (age 19-23 years). Subjects were classified into group (A) with 19 non-obese subjects and negative family history (FH) of cardiovascular diseases (CVD), group (B) with 38 non-obese subjects with a positive FH of CVD, and group (C) with 18 obese subjects with positive FH of CVD. Body composition was analyzed by bioelectrical impedance analysis. Cognitive functions were evaluated using the Cambridge Neuropsychological Automated Battery (CANTAB). The blood samples were tested for lipoprotein(a) [Lp(a)] and high-sensitivity C-reactive Protein (hs-CRP). RESULTS There was significantly prolonged Attention-Switching Task (AST) latency in obese subjects with negative family history of CVD (p=0.014) and those with positive family history of CVD (p=0.026) compared to controls, but the difference in AST Percent Correct Trials, Intra-Extra Dimensional Set Shift (IED) Total Errors, and Simple Reaction Time (SRT) was not significant. Simple response time had a weak but significant inverse correlation with BMI (r=-0.227, p<0.05). BMI was correlated positively with Lp(a) and hs-CRP, while BF% was correlated with hs-CRP only. No correlation was observed between the CANTAB tests, Lp(a), and hs-CRP. CONCLUSIONS Cardiovascular risk increases with higher adiposity and the presence of a positive family history of cardiovascular disease. Neurocognitive function may decline with higher adiposity; however, no relationship was observed between neurocognitive functions and cardiovascular risk markers.