Plastisch-chirurgische Rekonstruktion des männlichen Genitales

Mirastschijski, Ursula; Schwenke, Carla; Schmiedl, Andreas

doi:10.1007/978-3-662-57392-1_17

Cited by 4 publications

(5 citation statements)

References 11 publications

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“…Interestingly, almost no scarring is found after routine circumcision in men [31] . After traumatic skin loss of about half of the scrotal sac, the defect can be closed primarily with the remaining scrotal tissue [8,32] . Furthermore, abundant genital tissue provides the means for various local flaps which are commonly used for scrotal and penile reconstruction [33,34] or gender reassignment surgery [35] .…”

Section: Discussionmentioning

confidence: 99%

Wound repair and scarring of genital skin

Mirastschijski¹,

Jiang²,

Rinkevich³

et al. 2020

PAR

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Section: Discussionmentioning

confidence: 99%

Wound repair and scarring of genital skin

Mirastschijski¹,

Jiang²,

Rinkevich³

et al. 2020

PAR

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“…The genital dermis is rich in loosely packed elastic fibers ( Figure 3 ) to enable cutaneous adaptation to volume changes during erection, genital intercourse or childbirth. Of note, the penile size increases during erection within seconds by about 1.4 to 1.6-fold in length (unpublished data, [ 29 ]) and about 1.3-fold in circumference on average [ 29 , 30 ]. Excess skin with high elasticity and several fasciae allows for fast volume changes and tissue extension.…”

Section: Differences Between Genital and Non-genital Skinmentioning

confidence: 99%

“…In case of traumatic tissue loss, half of the scortal sac can be reconstructed from the remaining scrotal tissue [ 11 ], which is highly similar to the wound healing characteristics of the spiny mouse Acomys [ 54 ]. Furthermore, excess skin is useful for defect coverage of the penile shaft in obese men [ 55 , 56 ], after trauma [ 57 ] or tumor excision [ 30 , 57 ] or for genital reassignment surgery [ 58 ]. Of note, skin adjacent to the outer genitalia, e.g., groin, suprapubic or perineal skin in the vicinity of the thigh, have a tendency to excessive scarring, whereas hypertrophic scarring is rarely found in genital skin [ 15 ].…”

Section: Differences Between Genital and Non-genital Skinmentioning

confidence: 99%

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Genital Wound Repair and Scarring

2022

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Skin wound repair has been the central focus of clinicians and scientists for almost a century. Insights into acute and chronic wound healing as well as scarring have influenced and ameliorated wound treatment. Our knowledge of normal skin notwithstanding, little is known of acute and chronic wound repair of genital skin. In contrast to extra-genital skin, hypertrophic scarring is uncommon in genital tissue. Chronic wound healing disorders of the genitals are mostly confined to mucosal tissue diseases. This article will provide insights into the differences between extra-genital and genital skin with regard to anatomy, physiology and aberrant wound repair. In light of fundamental differences between genital and normal skin, it is recommended that reconstructive and esthetic surgery should exclusively be performed by specialists with profound expertise in genital wound repair.

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“…Full-or split-thickness skin grafts are the current gold standard for the reconstruction of penile skin defects [10][11][12] . Draw-backs of this technically simple and straightforward procedure are the tendency for scarring and the rigidity of the skin graft once it has taken.…”

Section: Introductionmentioning

confidence: 99%

Midline raphe scroti artery flap for penile shaft reconstruction

Mirastschijski¹,

Schwenke²,

Schwab³

et al. 2020

Plast Aesthet Res

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Aim: To investigate a novel method for penile shaft reconstruction. Methods: Penile tissue loss is caused by injury, infections, obesity or cancer resection. Reconstructive techniques comprise skin grafts with the risk of scarring and tissue rigidity. To develop an alternative reconstructive procedure, the pertinent vascular anatomy was studied on fresh cadavers instilled with red latex, which permitted the design of the midline raphe scrotal artery flap (MiRA). After anatomical proof-of-feasibility, penile reconstruction was performed in adult patients with classic buried penis or after cancer resection. Results: Anatomical studies revealed a novel finding of two scrotal septa, each with the terminal branch of the internal pudendal artery. Pedicled on both arteries, a neurovascular island flap could be harvested. In the presence of excess scrotal tissue, the entire circumference of the penile shaft could be covered by this flap. Patients with penile skin defects and excess scrotal tissue were eligible for flap harvest. The flap was raised either as an extended island flap pedicled on both septal arteries for complete penile shaft coverage, or as a VY-flap for partial reconstruction; the donor site was closed primarily. Post-operative complications included swelling or partial wound dehiscence. There were no flap losses or perfusion problems. Patients reported full sensitivity to the penile shaft skin and sufficient skin elasticity for erection.

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Plastisch-chirurgische Rekonstruktion des männlichen Genitales

Cited by 4 publications

References 11 publications

Wound repair and scarring of genital skin

Wound repair and scarring of genital skin

Genital Wound Repair and Scarring

Midline raphe scroti artery flap for penile shaft reconstruction

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