Archives of Hand and Microsurgery

The Korean Society for Surgery of the Hand (대한수부외과학회)
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Reconstruction of a Circumferential Penile Shaft Defect Using Bilateral Superficial External Pudendal Artery Perforator Flaps

양측 천외음부동맥 천공지 피판을 이용한 음경둘레 연조직 결손의 재건

  • Park, Jongohk (Department of Plastic and Reconstructive Surgery, Konkuk University Medical Center) ;
  • Shin, Donghyeok (Department of Plastic and Reconstructive Surgery, Konkuk University Medical Center) ;
  • Choi, Hyungon (Department of Plastic and Reconstructive Surgery, Konkuk University Medical Center) ;
  • Kim, Jeenam (Department of Plastic and Reconstructive Surgery, Konkuk University Medical Center) ;
  • Lee, Myungchul (Department of Plastic and Reconstructive Surgery, Konkuk University Medical Center)
  • 박종옥 (건국대학교병원 성형외과) ;
  • 신동혁 (건국대학교병원 성형외과) ;
  • 최현곤 (건국대학교병원 성형외과) ;
  • 김지남 (건국대학교병원 성형외과) ;
  • 이명철 (건국대학교병원 성형외과)
  • Received : 2018.08.03
  • Accepted : 2018.10.08
  • Published : 2018.12.01
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Abstract

Penile shaft reconstruction requires adequate soft tissue characteristics as well as constant vascular pedicles when considering a perforator flap. The free flap technique using various donor sites and regional conventional and perforator flaps have been utilized for penile shaft reconstruction. Still, the free flap techniques include challenging surgical procedures in addition to postoperative management. The regional flap can be applied to limited defects due to the size and shape. We performed the bilateral superficial external pudendal artery (SEPA) perforator flaps in order to reconstruct a circumferential penile shaft defect. The circumferential wound has noted necrotic tissue involving superficial (Dartos) fascia. We underwent debridement, preserving deep (Buck's) fascia and corpus spongiosum. Thereafter, the soft tissue defect was covered with bilateral SEPA perforator flaps. The patient has been observed for 27 months, showing penile resilience without deformity or wound-related problems.

음경 둘레 연조직 결손은 다양한 공여부를 이용하여 재건할 수 있으며, 유리피판술 및 국소피판술을 응용할 수 있다. 유리피판술의 경우 성공적인 결과를 위해 수술 과정 및 술 후 관리에 기술적인 어려움이 있으며, 기존 국소피판술은 결손 부위의 크기나 모양에 제약이 따르게 된다. 이에 양측 천외음부동맥 천공지피판을 이용한 음경둘레 연조직 결손 재건의 성공적인 사례를 발표하고자 한다. 음경 둘레 연조직 결손은 음낭근막까지 관찰되었으며, 변연절제술 시행 이후 심부근막과 해면체는 보존하였다. 이후 양측 천외음부동맥 천공지 피판을 이용하여 음경 전체 둘레연조직 결손 부위를 재건하였다. 27개월의 추적 관찰 기간 동안 음경의 형태와 기능은 보존되었으며, 창상치유와 연관된 문제는 관찰되지 않았다.

Keywords

References

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