CC BY 4.0 · European J Pediatr Surg Rep. 2017; 05(01): e47-e50
DOI: 10.1055/s-0037-1606282
Case Report
Georg Thieme Verlag KG Stuttgart · New York

Penile Reconstruction with Skin Grafts and Dermal Matrices: Indications and Management

Paloma Triana Junco
1   Department of Pediatric Surgery, Hospital Universitario La Paz, Madrid, Spain
Mariela Dore
1   Department of Pediatric Surgery, Hospital Universitario La Paz, Madrid, Spain
Vanesa Nuñez Cerezo
2   Department of Pediatric Surgery, Hospital La Paz, Madrid, Spain
Javier Jimenez Gomez
1   Department of Pediatric Surgery, Hospital Universitario La Paz, Madrid, Spain
Miriam Miguel Ferrero
2   Department of Pediatric Surgery, Hospital La Paz, Madrid, Spain
Mercedes Díaz González
2   Department of Pediatric Surgery, Hospital La Paz, Madrid, Spain
Pedro Lopez-Pereira
3   Department of Pediatric Urology, Hospital Universitario La Paz, Madrid, Spain
Juan Carlos Lopez-Gutierrez
4   Department of Pediatric Surgery, Division of Vascular Anomalies, La Paz Children's Hospital, Madrid, Spain
› Institutsangaben
Weitere Informationen


11. Juni 2017

16. Juli 2017

31. August 2017 (online)


Introduction The penis eventually needs specific cutaneous coverage in the context of reconstructive procedures following trauma or congenital anomalies. Local flaps are the first choice but are not always available after multiple previous procedures. In these cases, skin graft and dermal matrices should be considered.

Materials and Methods This study was a retrospective review of the past 4 years of four patients with severe loss of penile shaft skin who underwent skin reconstruction. Dermal matrices and skin grafts were utilized. Dermal matrices were placed for a median of 4.5 weeks (3.0–6.0 weeks). The skin graft was harvested from the inner thigh region for split-thickness skin graft (STSG) and the inguinal region for full-thickness skin graft (FTSG).

Results The four patients presented with complete loss of skin in the penile shaft. One patient had a vesical exstrophy, one had a buried penis with only one corpus cavernosum, one had a wide congenital lymphedema of the genitalia, and one had a lack of skin following circumcision at home. They underwent reconstruction with three patients undergoing split-thickness skin graft; two dermal matrices; and one full-thickness graft, respectively, thereby achieving a good cosmetic and functional result. There were no complications, and all the patients successfully accepted the graft.

Conclusion Dermal matrices and skin grafts may serve as effective tools in the management of severe penile skin defects unable to be covered with local flaps.

  • References

  • 1 Paediatric Urology Web book. 2nd ed. European Society for Paediatric Urology; 2014
  • 2 White N, Hettiaratchy S, Papini RP. The choice of split-thickness skin graft donor site: patients' and surgeons' preferences. Plast Reconstr Surg 2003; 112 (03) 933-934
  • 3 Thakar HJ, Dugi III DD. Skin grafting of the penis. Urol Clin North Am 2013; 40 (03) 439-448
  • 4 Alwaal A, McAninch JW, Harris CR, Breyer BN. Utilities of split-thickness skin grafting for male genital reconstruction. Urology 2015; 86 (04) 835-839
  • 5 Thompson JH, Zmaj P, Cummings JM, Steinhardt GF. An approach for using full thickness skin grafts for complex penile surgeries in children. J Urol 2006; 175 (05) 1869-1871 ; discussion 1871
  • 6 Asimakopoulos AD, Iorio B, Vespasiani G, Cervelli V, Spera E. Autologous split-thickness skin graft for penile coverage in the treatment of buried (trapped) penis after radical circumcision. BJU Int 2012; 110 (04) 602-606
  • 7 Gillett MD, Rathbun SR, Husmann DA, Clay RP, Kramer SA. Split-thickness skin graft for the management of concealed penis. J Urol 2005; 173 (02) 579-582
  • 8 Chertin B, Kocherov S, Binenboym R. , et al. Fenestrated sheet split-thickness skin grafting for reconstruction of penile skin loss in pediatric population. J Pediatr Surg 2016; 51 (08) 1362-1365
  • 9 Díaz EC, Corcoran JF, Johnson EK. Pediatric penile reconstruction using autologous split-thickness skin graft. J Pediatr Urol 2016; 12 (03) 185-186
  • 10 Alei G, Letizia P, Ricottilli F. , et al. Original technique for penile girth augmentation through porcine dermal acellular grafts: results in a 69-patient series. J Sex Med 2012; 9 (07) 1945-1953
  • 11 Ludolph I, Titel T, Beier JP. , et al. Penile reconstruction with dermal template and vacuum therapy in severe skin and soft tissue defects caused by Fournier's gangrene and hidradenitis suppurativa. Int Wound J 2016; 13 (01) 77-81
  • 12 Zhang Z, Lv L, Mamat M. , et al. Xenogenic (porcine) acellular dermal matrix promotes growth of granulation tissues in the wound healing of Fournier gangrene. Am Surg 2015; 81 (01) 92-95