Reconstruction of massive skin avulsion of the scrota and penis by combined application of dermal regeneration template(Pelnac) and split-thickness skin graft with vacuum-assisted closure: A case report

BACKGROUND Although skin avulsions to male external genitalia are rare, they can be both physically and psychologically traumatic. Thus, the necessity for judicious management poses significant challenges to surgeons in order to avoid potential permanent disabilities. We report a case of massive penoscrotal skin avulsion and a composite graft was creatively applied to cover the defect which achieved good results. We believe that this case is of great reference value for fellow surgeons.CASE SUMMARY A 52-year-old male presented with massive traumatic avulsion of the penile and scrotal skin following mishandling of an electric drill. The avulsed skin was missing. The patient was diagnosed with massive skin avulsion of external genitalia. Following initial complete debridement of devitalized or infected tissues, Pelnac dermal substitute was secured to the defect with the assistance of negative-pressure wound closure. In the final step, the silicone layer of Pelnac was removed and a split-thickness skin graft was applied. The defect had healed at the two-month follow-up. The patient now has normal erections and satisfactory sexual function.CONCLUSION Our experience with this wound repair demonstrated that the combination of a dermal regeneration template and a split-thickness skin graft with vacuumassisted closure is a safe, well-tolerated and efficient solution for the reconstruction of massive penoscrotal skin defects.

Polydopamine-modified collagen sponge scaffold as a novel dermal regeneration template with sustained release of platelet-rich plasma to accelerate skin repair:A one-step strategy

Although employed to release growth factors(GFs)for regenerative medicine,platelet-rich plasma(PRP)has been hindered by issues like burst effect.Based on collagen sponge scaffolds(CSSs)modified with polydopamine(pDA),a novel dermal regeneration template(DRT)was designed.However,whether it could efficiently deliver PRP and even foster wound healing remained unclear.In this work,after PRP was prepared and pDA-modified CSSs(pDA-CSSs)were fabricated,microscopic observation,GFs release assay and in-vitro biological evaluations of pDA-CSSs with PRP(pDA-CSS@PRP)were performed,followed by BALA-C/nu mice full-thickness skin defects implanted with pDA-CSS@PRP covered by grafted skins(termed as a One-step strategy).As a result,scanning electron microscope demonstrated more immobilized platelets on pDA-CSS′surface with GFs’controlled release via enzyme-linked immunosorbent assay,compared with CSSs.In line with enhanced in-vitro proliferation,adhesion and migration of keratinocytes&endothelial cells,pDA-CSS@PRP were histologically revealed to accelerate wound healing with less scar via rapid angiogenesis,arrangement of more mature collagen,guiding cells to spread,etc.In conclusion,pDA-CSSs have potential to serve as a novel DRT capable of delivering PRP,which may foster full-thickness skin defect healing by means of a One-step strategy.