title: [Fundamentals and principles of grafts and flaps].
abstract: Reconstructive surgery of large urethral stenosis and the management of congenital anomalies such as hypospadias and epispadias require covering large cutaneous and mucosal defects with different techniques. The objective of this work is to define the main differences between tissues to be transferred and to study the principles that must govern the management of the various flaps and grafts used for these techniques. We analyze the anatomical and physiological features that may be key to understand the success and possible failures of these procedures, and we review technical details that must accompany in every case, not only during the operation, but also during the preoperative and postoperative period. We conclude stating that grafts (mainly oral and preputial mucosa) and flaps are increasingly used for the repair of urethral stenosis. Grafts must be prepared adequately in the back table and thinned to the maximum, and also be fixed properly, to guarantee their immobility until neovascularization is assured.
authors: Unidad de Andrología y de Cirugia Reconstructiva Uretro-Genital. Unidad de Gestión Clinica de Urologia y Nefrologia. Hospital Virgen del Rocio. Sevilla.Spain.
authors: Natalio
authors: N
authors: Cruz-Navarro
authors: Eduardo
authors: E
authors: León-Dueñas
mesh_terms: D005500:Follow-Up Studies; D052816:Foreskin / Q000637:transplantation / Q000648:ultrastructure; D006801:Humans; D007021:Hypospadias / Q000601:surgery; D008297:Male; D009061:Mouth Mucosa / Q000637:transplantation / Q000648:ultrastructure; D009092:Mucous Membrane / Q000637:transplantation / Q000648:ultrastructure; D009928:Organ Specificity; D011182:Postoperative Care / Q000379:methods; D011183:Postoperative Complications; D011300:Preoperative Care / Q000379:methods; D019651:Plastic Surgery Procedures / Q000379:methods*; D012611:Scrotum; D012867:Skin / Q000648:ultrastructure; D016038:Skin Transplantation / Q000379:methods; D013524:Surgical Flaps / Q000098:blood supply; D014182:Transplantation, Autologous; D016042:Transplantation, Heterotopic; D014525:Urethral Stricture / Q000601:surgery*; D001743:Urinary Bladder; D013521:Urologic Surgical Procedures, Male / Q000379:methods*; D014945:Wound Healing / Q000502:physiology