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Dołączył: 13 Gru 2010
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 Wysłany: Czw 11:51, 10 Mar 2011 Temat postu: Hypospadias penis and scrotal skin flap in the app |
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Application of hypospadias surgery 103 patients with penile and scrotal flap
Road defects much, penis deformity is not severe abdominal flexor possible a complete, but this type is rare in clinical practice, the opposite bent penis deformity severe abdominal, urinary tract defects were more or staging operation as well. We take the penis thong buried under the law fascia in 52 cases, 28 cases of surgical failure, accounting for 53.84%. Reported slightly higher than the domestic Shutian Lin door of an inner room. The scrotal skin tube pedicle implantation in 51 cases, with the exception of urethral skin tube implantation in patients with stenosis, urinary leakage to be a small point-like expansion and anti-inflammatory on a regular basis, most can be healed, only 6 cases of which occurred concurrently disease, accounted for l1.8%. Operation, the key is to be measured, preoperative absence of catheter length, design better implants skin tube length and width; free skin tube pedicle blood supply good note; suture suture skin tube spacing is moderate, the transfer hose must The flap suture the wound close to the ventral penile wounds in its rich blood supply to the easy-adhesion healing. In the complications [3 - ~ q, wound infections were more common, the reason is not controlled preoperative urinary tract infections, skin cleansing and disinfection are not repeated, the body has not been corrected poor nutritional status, intraoperative bleeding is not complete, hematoma formation , residual thread too, wound contamination, poor drainage and other reasons. Therefore, preoperative preparation should be strictly to do the above work, is to prevent infection as well as the key to surgical failure. Cracked skin necrosis, more common in the skin free skin tube is too narrow and there is tension release the stent, so the width should be designed to moderate skin and skin tube. If the blood supply in pedicle skin bad, can also occur away from the part of the vascular pedicle skin flap necrosis, flap cut method of illumination can be checked when the flap blood supply Traveling situation, keeping arteries. Tight wound dressings,[link widoczny dla zalogowanych], penile erection frequency, constipation and other factors can lead to skin breakdown is the reason. Urinary fistula, urinary fistula perineal fistula compared with the high incidence of penile type, it is designed to make this type of skin on both sides of the scrotum or along the top of the original urethra inclined to take enough skin flap to ensure successful operation. Early formation of individual patients small urethral fistula hole, removal of stent, regularly cleaned and disinfected more than able to heal itself, can not blindly expand fistula drainage, otherwise it will backfire. Penile curvature, and more as a rise of surgery is not complete,[link widoczny dla zalogowanych], the penis with free removal of the ventral fiber cable is not sufficient, plus the original urethral orifice is not fully free, not to the original urethra downward shift in some patients the ventral penis albuginea hypoplasia, even if the removal of local straps penis extension is also not satisfied. Patients with the best rubber band ligation penis, intracavernosal injection of saline, to observe the straight,[link widoczny dla zalogowanych], and some can be taken to the dorsal penile tunica albuginea in patients with folded suture, correctable deformity is not satisfied with the penile curvature. In summary, we believe that the ventral penile skin flap using penile fascia thong buried in the law only under the curve for the in situ cracks or urethra close to the coronary sulcus after correction for patients,[link widoczny dla zalogowanych], surgery is better. On the contrary, for the breach or the next song, after correction of penile urethra down close to the scrotum or perineal community who is poor, but in different directions to take flexible pedicle scrotal flap urethroplasty is a better surgical methods, received good treatment of clinical effect,[link widoczny dla zalogowanych], should be widely applied. [
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