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01-12-2023 | Skin Graft | Original Article

Surgical approach to penile reconstruction for shaft skin excision from circumcision

Authors: Thomas G. W. Harris, Preeya Khandge, Wayland J. Wu, Angelo A. Leto Barone, Jordan P. Steinberg, Richard J. Redett III, John P. Gearhart

Published in: Pediatric Surgery International | Issue 1/2023

Abstract

Purpose

Circumcision is one of the most frequently performed surgical procedures. Complications are infrequent, including bleeding, though can be significant such as shaft skin excision. The aim of this study was to identify mechanism of injury and reconstructive techniques for skin excision using a full thickness skin graft (FTSG) or with the novel application of tissue expanders (TE).

Methods

Patients who underwent penile reconstruction following shaft skin excision from an overzealous circumcision were retrospectively reviewed. The penis was covered using a FTSG, harvested from the groin/hip, or using TE, with expanders placed in residual shaft skin.

Results

Twelve patients experienced significant skin loss (range 65–95%) including 2 with partial glans loss. Ten were reconstructed using a FTSG and 2 with TE. Injury was most frequently from a Mogen clamp (n = 9), or from a Gomco clamp, Plastibell device, and electrocautery burns. Six FTSG patients experienced complications with lymphedema (n = 3) most common.

Conclusion

Shaft skin excision is a devastating complication with risk greatest from Mogen clamp use. TE is preferred as this avoids donor site morbidity which reassures parents but requires sufficient residual skin that can be expanded. Both techniques effectively provide soft tissue coverage with acceptable appearance and long-term function.

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Title: Surgical approach to penile reconstruction for shaft skin excision from circumcision
Authors: Thomas G. W. Harris
Preeya Khandge
Wayland J. Wu
Angelo A. Leto Barone
Jordan P. Steinberg
Richard J. Redett III
John P. Gearhart
Publication date: 01-12-2023
Publisher: Springer Berlin Heidelberg
Keywords: Skin Graft
Circumcision
Lymphedema
Circumcision
Published in: Pediatric Surgery International / Issue 1/2023
Print ISSN: 0179-0358
Electronic ISSN: 1437-9813
DOI: https://doi.org/10.1007/s00383-023-05409-x

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Surgical approach to penile reconstruction for shaft skin excision from circumcision

Abstract

Purpose

Methods

Results

Conclusion

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Purpose

Methods

Results

Conclusion

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