Use of a hypogastric flap and split-thickness skin grafting for a degloving injury of the penis and scrotum: A different approach

ABSTRACTPenile and scrotal skin avulsions are not common events and are caused usually by accidents with industrial machines or agricultural machines. We report a case of a 27-year-old newly married thin-built patient with avulsion and traumatic degloving of the penile and scrotal skin, with exposure of the corpora cavernosa and copus spongiosum of penis and testes as his loose clothes got entangled in a paddy harvesting machine accidently. Reconstruction was performed using a hypogastric flap and split skin graft, achieving a satisfactory aesthetic result and sexual functions.

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Regrafting of the Split-Thickness Skin Graft Donor-Site: Is It Beneficial?

Journal of Burn Care & Research ◽

10.1093/jbcr/irz166 ◽

2019 ◽

Author(s):

Catherine M Legemate ◽

Ymke Lucas ◽

Irma M M H Oen ◽

Cornelis H Van Der Vlies

Keyword(s):

Skin Graft ◽

Donor Site ◽

Skin Grafting ◽

Split Thickness Skin Graft ◽

Split Skin Graft ◽

Thickness Skin ◽

Split Skin Grafting ◽

Split Thickness Skin Grafting ◽

Graft Donor ◽

Split Skin

Abstract Split-thickness skin grafting remains a fundamental treatment for patients with deep burns and other traumatic injuries. Unfortunately, the donor site wound that remains after split skin graft (SSG) harvesting may also cause problems for the patient; they can lead to discomfort and scars with a poor cosmetic outcome. Regrafting of the donor site is one of the methods described to improve donor site healing and scarring. In this report, we describe a case of a 26-year-old woman with a self-inflicted chemical burn (0.5% TBSA) who underwent split skin grafting. During surgery, only part of the donor site was regrafted with split skin graft remnants. This part healed faster and had a better scar quality at 3 months postsurgery. Nevertheless, the appearance and patients’ opinion on the regrafted part deteriorated after 12 months. With this case report, we aim to create awareness of the long-term consequences of regrafting, which may differ from short-time results. Patients expected to have poor reepithelialization potential may benefit from regrafting of the SSG on the donor site. But in healthy young individuals, timewise there would be no benefit since it can lead to an aesthetically displeasing result.

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Degloving Penile Injury with Urethral Avulsion: A Case Report

IIUM Medical Journal Malaysia ◽

10.31436/imjm.v18i1.796 ◽

2019 ◽

Vol 18 (1) ◽

Author(s):

Sivanandhan S ◽

Sivaneswaran L

Keyword(s):

Skin Grafting ◽

Urethral Injury ◽

Wound Debridement ◽

Degloving Injury ◽

Thickness Skin ◽

Operative Exploration ◽

Split Thickness Skin Grafting ◽

Delayed Complication ◽

Skin Loss ◽

Penile Injury

Accidental male genital injuries represent a serious urological disorder that demands immediate urological treatment due to risk of infection and need for fertility preservation. We reported a 30- year-old gentleman who presented with an extensive penile degloving injury, right open pneumothorax and right thigh laceration following a buffalo attack. Examination under anesthesia (EUA) demonstrated ruptured penis with tearing up to penile base and partially avulsed right testis. Right orchidectomy, wound debridement and suprapubic catheter insertion performed before being referred to Penang General Hospital. Repeated EUA revealed avulsed penile urethra 3cm from the meatus with interposing granulation tissue of 2cm in length. He underwent serial wound debridement and eventually required a split skin graft to the penis. Patient was reported to be able to achieve penile erection by 2 months post-operative and planned for urethroplasty later. This is the first paper that reports an incident of buffalo attack resulting in degloving injury of penis. Management depends on severity of trauma and prompt intervention essential to prevent immediate as well as delayed complication. Urethral injury must be considered in any extensive penile injury. Despite multiple modality for traumatic penile skin loss repair, split thickness skin grafting (SSG) was chosen for this patient. Conclusion: External injuries of the genitals, particularly caused by animal attack, should be followed by immediate operative exploration and if necessary, to reparative measures. Care must be taken with goal of optimizing long term sexual, cosmetic and voiding outcomes.

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TOTAL PENILE DEGLOVING INJURY RESURFACED WITH A SPLIT SKIN GRAFT – A CASE REPORT

10.36106/ijsr/3506945 ◽

2021 ◽

pp. 40-41

Author(s):

Surya Rao Rao Venkata Mahipathy ◽

Alagar Raja Durairaj ◽

Narayanamurthy Sundaramurthy ◽

Anand Prasath Jayachandiran ◽

Suresh Rajendran

Keyword(s):

Skin Graft ◽

Split Skin Graft ◽

Full Thickness Skin Graft ◽

Erectile Tissue ◽

Degloving Injury ◽

Thickness Skin ◽

Free Skin Graft ◽

Degloving Injuries ◽

Thorough Debridement ◽

Split Skin

Degloving injuries of the penis are a rare occurrence often requiring reconstruction. They are usually caused by industrial or agricultural machinery and tend to involve both the penile shaft and the scrotal skin with young adults being the usual victims. A penile degloving usually begins just proximal of the coronal line and progress down to the base of the shaft. Deep erectile tissue and the spermatic cord are usually undamaged and the endogenous skin of glans usually survives. The management requires thorough debridement and resurfacing the raw area by either using the degloved skin as a ap or a free skin graft, or by using a split skin or a full thickness skin graft. Here, we report a case of a total penile skin degloving managed with a split skin graft with satisfactory cosmetic result.

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The Split Skin Graft Donor Site: Can Pretreatment with Vitamin a Cream Help?

Canadian Journal of Plastic Surgery ◽

10.1177/229255030201000208 ◽

2002 ◽

Vol 10 (2) ◽

pp. 78-80

Author(s):

Pj Skoll ◽

M Soldin ◽

M Grob ◽

B Seymour ◽

J Davies ◽

...

Keyword(s):

Vitamin A ◽

Skin Graft ◽

Donor Site ◽

Skin Grafting ◽

Hot Water ◽

Split Skin Graft ◽

Clinical Criteria ◽

Split Thickness Skin Grafting ◽

Graft Donor ◽

Split Skin

Background A skin graft donor site that heals rapidly with less cosmetic sequelae is of particular benefit to children with burns. Vitamin A cream has been shown to speed up healing after controlled ‘burns’ (dermabrasion and CO2 laser) if it is applied six weeks before treatment. Objective To assess whether pretreatment with vitamin A cream increases the rate of healing of split skin graft donor sites in children with burns. Methods Prospective study of children with hot water burns of 8% to 30% that required split thickness skin grafting. Vitamin A cream was applied bidaily to one thigh and/or buttock of each child for five to seven days before skin grafting. At surgery, equal thickness grafts were harvested from both thighs and/or buttocks. Biopsies were taken from each thigh and/or buttock and were sent for histological analysis. The rate of donor site healing was monitored clinically and with serial photographs. Results No difference in the rate of healing was noted between the treated and untreated sides by either histological or clinical criteria. Conclusions Vitamin A cream applied bidaily for a period of five to seven days did not affect the healing rate of the split skin graft donor sites in children with burns.

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Use of a hypogastric flap and split-thickness skin grafting for a degloving injury of the penis and scrotum: A different approach

Indian Journal of Plastic Surgery ◽

10.4103/0970-0358.59296 ◽

2009 ◽

Vol 42 (2) ◽

pp. 265 ◽

Cited By ~ 7

Author(s):

SengathirS Selvan ◽

GaneshS Alagu ◽

R Alagu

Keyword(s):

Skin Grafting ◽

Degloving Injury ◽

Thickness Skin ◽

Split Thickness Skin Grafting

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Surgical Outcome in Tumescent and Non-Tumescent Method of Harvesting Split Skin Graft - An Observational Study at KR Hospital, Mysuru

Journal of Evidence Based Medicine and Healthcare ◽

10.18410/jebmh/2021/433 ◽

2021 ◽

Vol 8 (26) ◽

pp. 2322-2327

Author(s):

Anandaravi B.N. ◽

Manjunath R.D. ◽

Puneeth D.N

Keyword(s):

Observational Study ◽

Skin Graft ◽

Local Anaesthesia ◽

Split Skin Graft ◽

Tumescent Technique ◽

Thickness Skin ◽

Split Thickness Skin Grafting ◽

Group A ◽

Group B ◽

Split Skin

BACKGROUND The study was started with the aim to determine take up rate in tumescent technique compared to non-tumescent technique for harvesting split skin graft. Tumescent technique has been practiced for over forty years especially in liposuction. Tumescent anaesthesia is a combination of crystalloid, lignocaine, adrenaline and sodium bicarbonate. Using tumescent local anaesthesia for harvesting a split thickness skin graft is not in much practise. This study was designed to provide strong evidence of this technique. METHODS This was an observational study. Two treatment groups of patients, tumescent (group A, N = 21) and non-tumescent technique (group B, N =21), who fulfilled the inclusion criteria were randomly assigned. Tumescent technique involved administration of Klein’s formula. No prior administration of agent was performed in non-tumescent technique. The recipient site was opened in both groups on the fifth day after surgery and take rate assessed. RESULTS The difference in take up rate between the two groups was found to be statistically significant. Compared to the patients in group B, patients who underwent tumescent technique (group A) had higher take up rate (> 12 %, P = 0.005). We did not find any statistically significant difference in donor site percentage healing between the tumescent and non-tumescent groups, P = 0.379. CONCLUSIONS Tumescent technique gives better take up results and is more effective than nontumescent technique in harvesting split skin graft. The subdermal injection creates a smooth, dense surface which assists donor harvesting. This can be implemented preoperatively in split-thickness skin grafting. KEYWORDS Split Skin Graft, Take Up Rate, Harvesting, Tumescent, Non-Tumescent, Local Anaesthesia

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