title: Use of the scrotal remnant as a tissue-expanding musculocutaneous flap for scrotal reconstruction in Paget's disease.
abstract: Wide excision of extramammary Paget's disease of the penoscrotal region may leave large defects that cannot be closed easily. The authors describe their experience with a series of 6 patients in whom reconstruction of the scrotal defect was undertaken using the scrotal remnant raised as a stretchable musculocutaneous flap. It was observed that as little as a third of the residual scrotum could be expanded to resurface the entire scrotum. All flaps survived completely. Severe scrotal edema and ecchymosis were observed in 1 patient but the symptoms resolved completely with Trendelenburg positioning. The penile defects were resurfaced individually with thick skin grafts. Good-quality take with no chordee was observed in all patients after initial reconstruction. One patient developed penile contracture after reexcision of recurrent disease. Mean follow-up was 22 months (range, 3-60 months). Large defects of as much as two thirds of the scrotum may be reconstructed successfully using the tissue-expanding scrotal musculocutaneous flap.
authors.affiliation: Department of Plastic Surgery, Singapore General Hospital, Singapore.
authors.forename: Yong-Chen
authors.initials: YC
authors.lastname: Por
authors.forename: Bien-Keem
authors.initials: BK
authors.lastname: Tan
authors.forename: Soo-Wan
authors.initials: SW
authors.lastname: Hong
authors.forename: Sing-Joo
authors.initials: SJ
authors.lastname: Chia
authors.forename: C W S
authors.initials: CW
authors.lastname: Cheng
authors.forename: Chee-Liam
authors.initials: CL
authors.lastname: Foo
authors.forename: Kok-Chai
authors.initials: KC
authors.lastname: Tan
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D006801:Humans; D008297:Male; D008875:Middle Aged; D010145:Paget Disease, Extramammary / Q000601:surgery*; D010412:Penile Neoplasms / Q000601:surgery*; D010413:Penis / Q000601:surgery*; D019651:Plastic Surgery Procedures / Q000379:methods*; D012611:Scrotum / Q000098:blood supply / Q000601:surgery*; D013524:Surgical Flaps; D016896:Treatment Outcome