title: De-epithelialized skin flap coverage in hypospadias repair.
abstract: The results in 84 hypospadias repairs using a de-epithelialized skin flap are reported. A variety of 1-stage repairs were applied including those of King, Mathieu, Mustardé and Duckett, and a combined midline and transverse island flap for perineal hypospadias. In each repair a flap of transposed prepuce was swung ventral, de-epithelialized and applied over the urethroplasty. In all but 2 repairs complete coverage of the urethra was achieved by this technique. Reoperation was required in 7 patients (8 per cent) but in only 3 (3.5 per cent) ws this to close a urethrocutaneous fistula. The addition of a de-epithelialized flap to create a layer completely covering the neourethra appears to reduce the incidence of fistulas significantly.
mesh_terms: D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D006801:Humans; D007021:Hypospadias / Q000628:therapy*; D008297:Male; D008488:Medical Illustration; D010413:Penis; D011183:Postoperative Complications; D012086:Reoperation; D016038:Skin Transplantation; D013524:Surgical Flaps; D014521:Urethra / Q000601:surgery