Outcomes of islanded scrotal raphe flap employment for skin shortage in complicated hypospadias repair

xlomafota13 shared this article with you from Inoreader Outcomes of islanded scrotal raphe flap employment for skin shortage in complicated hypospadias repair Via Journal of plastic, reconstructive & aesthetic surgery : JPRAS J Plast Reconstr Aesthet Surg. 2021 Jun 9:S1748-6815(21)00275-8. doi: 10.1016/j.bjps.2021.05.023. Online ahead of print. ABSTRACT BACKGROUND: Ventral skin deficiency in complicated hypospadias is a difficult problem to treat. The aim of our study is to report our technique and outcomes of vascularized islanded scrotal raphe flap for ventral skin deficiency in complicated hypospadias. METHODS: A retrospective review was conducted at Northwest General Hospital & Research Centre, Peshawar, from January 2012 to January 2019. Complicated hypospadias patients who underwent two-stage surgery employing islanded scrotal flap were identified. Patients underwent surgery in two stages: scar tissue removal, chordee correction and buccal mucosal graft in the first stage; neourethral tubularization, water proofing, and skin coverage with vascularized islanded scrotal raphe flap in the second stage. The primary outcome was 6-month flap survi val rate. Secondary outcomes were 6-month complication rate (fistula, persistent chordee, distal stenosis) and end-of-follow-up patient self-reported satisfaction rate. RESULTS: A total of 1845 patients underwent hypospadias surgery, of which 380 patients had complications. Scrotal raphe flap was used in 45 patients. Mean age was 14.09 (±8.02) years. Mean follow-up was 29.78 (±12.18) months. Mean number of previous surgeries was 4.31 (±2.59). The flap survived in all cases. Nine patients (20%) developed complications. One patient (2.2%) developed distal stenosis. Eight patients (17.8%) developed fistulas, one of whom additionally had persistent chordee. Five fistulas closed spontaneously within 3 months, while the rest were repaired surgically after 6 months. All patients self-reported satisfaction with results at end-of-follow-up. CONCLUSIONS: Islanded Scrotal Raphé flap is a promising option for treating complicated hypospadias when there is significant ventral def iciency of skin, as it not only provides vascularized pliable skin but also fascia as a waterproofing layer. PMID:34247964 | DOI:10.1016/j.bjps.2021.05.023 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.