自制外固定支架在Mohs手术后阴茎缺损植皮术中的应用

Application of self-made external support in penile defect skin grafting after Mohs surgery

目的:探讨自制外固定支架在Mohs手术后全阴茎植皮术后修复皮肤大面积缺损中的作用。方法:对2022年1月至2023年12月我院17例Mohs手术治疗的乳房外Paget病患者阴茎皮片移植成活率进行回顾性分析。结果:17例患者使用外固定支架的共12例,其中10例(83%)患者术后创面一期愈合,移植皮片完全成活,2例患者阴茎根部皮缘部分坏死后二期愈合;使用常规打包法的患者共5例,其中3例术后创面一期愈合(60%),1例阴茎腹侧皮片部分坏死后二期愈合,1例患者阴茎根部皮片环形坏死后二期愈合;术后随访6~24个月,肿瘤无复发,使用外固定支架的患者对阴茎形态及功能的满意度均高于使用常规打包法的患者。结论:自制外支架固定全阴茎植皮术可显著提高游离皮片移植成活概率,并为大面积乳房外Paget病术后缺损修复提供了一个简单、有效的方法。

Objective:To investigate the clinical effect of self-made external support in total penile skin grafting for the repair of large skin defect after Mohs surgery.Methods:The survival rate of skin in 17 cases with extramarammy Paget's disease treated with Mohs surgery in our hospital from January 2022 to December 2023 were retrospectively analyzed.Results:Of 17 patients,12 patients were treated with external support,of which 10 patients were healed primarily and the graft completely survived,and 2 patients were healed by second intention after partial necrosis of the skin margin at the root of the penis.A total of 5 patients were treated with conventional packing method,of which 3 patients were healed primarily,1 patient was healed by second intention after partial necrosis of the ventral penis skin,and 1 patient was healed by second intention after circular necrosis of the penis root skin.After 6 to 24 months of follow-up,there was no recurrence of tumor,and the satisfaction rate of penile morphology and function of patients using external support was higher than that of patients using conventional packing method.Conclusion:Self-made external support in total penile skin grafting can significantly improve the survival rate of free skin transplantation,and provide a simple and effective method for the repair of large defects of the extramarammy Paget's disease.