a novel skin management scheme in surgery of epispadias undergoing cantwell-ransley repair a technique to improve the aesthetics and minimize complications：一种在经历坎特兰斯利修复技术提高美学和减少并发症尿道上裂手术皮肤管理方案.pdfVIP

Pediatric Urology A Novel Skin Management Scheme in Surgery of Epispadias Undergoing Cantwell-Ransley Repair: A Technique to Improve the Aesthetics and Minimize Complications Shiv Narain Kureel, Archika Gupta, Chandra Shekhar Singh, and Jiledar Rawat OBJECTIVE To describe a new scheme of skin cover in epispadias repair to improve the aesthetic results and minimize complications. PATIENTS AND In the last 4 years, 7 male continent epispadias (aged 2-5 years) undergoing Cantwell-Ransley METHODS repair received a new technique of skin cover. After a U-shaped incision along the margin of urethral plate, a transverse incision beginning at the margin of urethral plate 7-10 mm proximal to the corona was carried along the prepucial edge upto the corresponding point at urethral plate margin on the other side. The prepuce was split into a dorsal flap attached to the corona and a ventral flap continuous with penile skin. After subdartos degloving, incision through median raphe upto penoscrotal junction bifurcated the penile skin-dartos complex. After Cantwell- Ransley repair, reverse advancement of inner prepucial flap provided skin cover to most of the ventral aspect of penile shaft. Dorsal midline union of bifurcated penile skin-dartos flaps provided dorsolateral cover. At ventral midline, limited joining of penile skin-dartos flaps at penoscrotal junction and anchoring to corpus spongiosum created penoscrotal angle with shaft cover at penoscrotal junction. Lateral margins of dorsal and ventral skin cover were joined. RESULTS There was no flap necrosis, penile ro