Penile amputation following adult circumcision

Male circumcision is a routine cultural ritual in the neonates among Igbo tribe in southeast Nigeria. Adult circumcision is not a common practice and circumcision is rarely complicated by amputation. It is a major source of distress for the patient, and a reconstructive challenge to the care giver. Use of skin graft has been described in glans resurfacing. However, it is difficult to keep the graft in place in the early post operative period. A 32 years-old man presented to us with penile amputation and urethral stenosis following circumcision by a midwife. Initial attempt at reconstruction failed before he was referred to us. We used Split Thickness Skin Graft (STSG) with tie-over dressing for resurfacing. Penile amputation is an uncommon complication of adult circumcision and should be left for professionals to avoid such mishap. Satisfactory outcome can be achieved by STSG if sufficient length is preserved.

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Improving Outcomes in Anterolateral Thigh Flap Donor-Site Reconstruction Using Propeller Flaps: A Retrospective Comparative Study with Skin Grafting

Journal of Reconstructive Microsurgery ◽

10.1055/s-0040-1718550 ◽

2020 ◽

Author(s):

Domenico Pagliara ◽

Maria Lucia Mangialardi ◽

Stefano Vitagliano ◽

Valentina Pino ◽

Marzia Salgarello

Keyword(s):

Comparative Study ◽

Skin Graft ◽

Donor Site ◽

Split Thickness Skin Graft ◽

Tactile Sensitivity ◽

Aesthetic Outcome ◽

Propeller Flap ◽

Thickness Skin ◽

Anterolateral Thigh ◽

Alt Flap

Abstract Background After anterolateral thigh (ALT) flap harvesting, skin graft of the donor site is commonly performed. When the defect width exceeds 8 cm or 16% of thigh circumference, it can determine lower limb function impairment and poor aesthetic outcomes. In our comparative study, we assessed the functional and aesthetic outcomes related to ALT donor-site closure with split-thickness skin graft compared with thigh propeller flap. Methods We enrolled 60 patients with ALT flap donor sites. We considered two groups of ALT donor-site reconstructions: graft group (30 patients) with split-thickness skin graft and flap group (30 patients) with local perforator-based propeller flap. We assessed for each patient the range of motion (ROM) at the hip and knee, tension, numbness, paresthesia, tactile sensitivity, and gait. Regarding the impact on daily life activities, patients completed the lower extremity functional scale (LEFS) questionnaire. Patient satisfaction for aesthetic outcome was obtained with a 5-point Likert scale (from very poor to excellent). Results In the propeller flap group, the ROMs of hip and knee and the LEFS score were significantly higher. At 12-month follow-up, in the graft group, 23 patients reported tension, 19 numbness, 16 paresthesia, 22 reduction of tactile sensitivity, and 5 alteration of gait versus only 5 patients experienced paresthesia and 7 reduction of tactile sensitivity in the propeller flap group. The satisfaction for aesthetic outcome was significantly higher in the propeller flap group. Conclusion In high-tension ALT donor-site closure, the propeller perforator flap should always be considered to avoid split-thickness skin graft with related functional and aesthetic poor results.

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A randomized single-blind controlled study of cultured epidermal allografts in the treatment of split-thickness skin graft donor sites

Archives of Dermatology ◽

10.1001/archderm.129.7.879 ◽

1993 ◽

Vol 129 (7) ◽

pp. 879-882 ◽

Cited By ~ 9

Author(s):

T. J. Phillips

Keyword(s):

Skin Graft ◽

Controlled Study ◽

Split Thickness Skin Graft ◽

Thickness Skin ◽

Graft Donor ◽

Single Blind

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Application of a Split-thickness Skin Graft after the Removal of Huge Cutaneous Squamous Cell Carcinoma on the Right Lower Posterior Neck and Right Shoulder: Case Report

Korean Society for Head and Neck Oncology ◽

10.21593/kjhno/2016.32.1.45 ◽

2016 ◽

Vol 32 (1) ◽

pp. 45-48

Author(s):

Jong Chan Kim ◽

◽

In Pyo Hong ◽

Keyword(s):

Squamous Cell Carcinoma ◽

Case Report ◽

Cell Carcinoma ◽

Squamous Cell ◽

Skin Graft ◽

Cutaneous Squamous Cell Carcinoma ◽

Split Thickness Skin Graft ◽

Thickness Skin ◽

Posterior Neck ◽

The Right

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Reconstruction of a secondary scalp defect using the crane principle and a split-thickness skin graft

BMC Surgery ◽

10.1186/s12893-021-01056-y ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Yi Lu ◽

Ke-Chung Chang ◽

Che-Ning Chang ◽

Dun-Hao Chang

Keyword(s):

Skin Graft ◽

Subcutaneous Tissue ◽

Donor Site ◽

Split Thickness Skin Graft ◽

Salvage Procedure ◽

Primary Defect ◽

Scalp Defects ◽

Thickness Skin ◽

Scalp Defect ◽

Secondary Defect

Abstract Background Scalp reconstruction is a common challenge for surgeons, and there are many different treatment choices. The “crane principle” is a technique that temporarily transfers a scalp flap to the defect to deposit subcutaneous tissue. The flap is then returned to its original location, leaving behind a layer of soft tissue that is used to nourish a skin graft. Decades ago, it was commonly used for forehead scalp defects, but this useful technique has been seldom reported on in recent years due to the improvement of microsurgical techniques. Previous reports mainly used the crane principle for the primary defects, and here we present a case with its coincidental application to deal with a complication of a secondary defect. Case report We present a case of a 75-year-old female patient with a temporoparietal scalp squamous cell carcinoma (SCC). After tumor excision, the primary defect was reconstructed using a transposition flap and the donor site was covered by a split-thickness skin graft (STSG). Postoperatively, the occipital skin graft was partially lost resulting in skull bone exposure. For this secondary defect, we applied the crane principle to the previously rotated flap as a salvage procedure and skin grafting to the original tumor location covered by a viable galea fascia in 1.5 months. Both the flap and skin graft healed uneventfully. Conclusions Currently, the crane principle is a little-used technique because of the familiarity of microsurgery. Nevertheless, the concept is still useful in selected cases, especially for the management of previous flap complications.

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