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Reconstruction of penile skin loss using a combined therapy of negative pressure wound therapy, dermal regeneration template, and split-thickness skin graft application

International Journal of Impotence Research volume 33, pages 854–859 (2021)Cite this article

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Abstract

This study evaluates the use of acellular dermal matrix (ADM) in conjunction with negative pressure wound therapy (NPWT) and delayed split-thickness skin graft (STSG) application as an alternative to free tissue transfer for defect coverage of the penile shaft. Five patients with genital lymphedema and one with penile skin deficiency underwent penile shaft reconstruction with a two-stage surgical procedure. The first procedure aimed to the correction of skin defect and to neodermis regeneration through the use of an ADM (Integra®, Integra Lifesciences Corp., Plainsboro, NJ, USA) and NPWT. The second procedure 3 weeks later aimed to the covering of the skin defect with an unmeshed STSG. Both the Integra and skin graft showed completely taking at 7 days postop. No major complications occurred. At 6 months grafts gained sufficient elasticity to allow the sliding of the epidermis over the dermal layer, similarly the physiological penile shaft skin. Our results suggest that combined therapy might be an alternative to free tissue transfer for defect coverage of the penile shaft, leading to a good esthetic result, an optimal shaft coverage and providing adequate extensibility during erections. For best results we advise that in these cases urologists should collaborate with plastic surgeons.

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Fig. 1: Preoperative presentation.
Fig. 2: Negative-pressure dressing.
Fig. 3: Postoperative result.

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Author notes

  1. These authors contributed equally: Liguori Giovanni, Papa Giovanni

Authors and Affiliations

  1. Department of Urology, University of Trieste, Trieste, Italy

    Giovanni Liguori, Matteo Boltri, Michele Rizzo, Nicola Pavan & Carlo Trombetta

  2. Department of Plastic Surgery, University of Trieste, Trieste, Italy

    Giovanni Papa, Chiara Stocco, Alessia De Grazia, Vittorio Ramella & Zoran Marij Arnež

Authors
  1. Giovanni Liguori
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  2. Giovanni Papa
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  3. Matteo Boltri
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  4. Chiara Stocco
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  5. Alessia De Grazia
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  6. Michele Rizzo
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  7. Nicola Pavan
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  8. Vittorio Ramella
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  9. Carlo Trombetta
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  10. Zoran Marij Arnež
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Correspondence to Giovanni Liguori.

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Liguori, G., Papa, G., Boltri, M. et al. Reconstruction of penile skin loss using a combined therapy of negative pressure wound therapy, dermal regeneration template, and split-thickness skin graft application. Int J Impot Res 33, 854–859 (2021). https://doi.org/10.1038/s41443-020-00343-1

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