Objective: To summarize the experience of repair and reconstruction of penile defects as a result of devastating deep burn.
Methods: Twenty-four patients with penile defects in early or late (a half year after wound healed, the same below) stage after burn were involved. Their suspensory ligaments of penis were dissected to lengthen the penis after escharotomy with the necrotic distal part removed. The wounds formed after lengthening were covered with lower abdominal skin flap, scrotal or internal pudendal artery flap. Ten patients underwent surgery within 30 days after burn; the other 14 patients underwent surgery in the late stage. The condition of flaps and complications after surgery were observed. The lengths of penis of patients in flaccid and erection state were measured before surgery and at follow-up period. The sensory function of penile skin, the erectile function of the penis, and sexual intercourse activity of patients were followed up.
Results: All the flaps survived except two, in whom areas of 1.0 cm x 0.5 cm and 1.5 cm x 1.0 cm of necrosis at distal parts were found, and they healed after dressing changes. Patients were followed up for 2 to 5 years. The length of penis in flaccid state was (7.4 +/- 1.6) cm, which was (5.3 +/- 1.4) cm longer than that before surgery (P < 0.01). The length of penis in erection state was (9.7 +/- 1.2) cm. The sensory function of penis recovered gradually about half year after surgery with well preserved erectile function. Except one who did not try to have sexual intercourse again, all the other married patients and their spouses were satisfied or quite satisfied with sexual intercourse activity.
Conclusions: Penis elongation combined with skin flap grafting is a good method for the treatment of penile defects due to devastating deep burn. Suitable length and erectile function of penis can be preserved with this method.