title: Penile reconstruction with dermal template and vacuum therapy in severe skin and soft tissue defects caused by Fournier's gangrene and hidradenitis suppurativa.
abstract: The aim of this article is to improve the treatment of patients with complete skin loss of the penile shaft after Fournier's gangrene or hidradenitis suppurativa using modern biomatrices and topical negative pressure therapy. From January 2010 to December 2011, three patients with Fournier's gangrene or hidradenitis suppurativa were treated. After initial radical debridements, topical negative pressure therapy was applied for wound stabilisation. After that dermal templates (acellular dermal matrix) were used to achieve early healing and topical negative pressure-dressing in a special setting or a special foam compression bandage was used together with a urinary catheter. After integration of the dermal template, a split-thickness skin graft is used for coverage and again secured with a circular total negative pressure-dressing. In all cases, the split-thickness skin grafts healed very well applying this therapy concept. The patients were very satisfied with the functional as well as with the aesthetic outcome. We suggest a new method of staged reconstruction to successfully preserve the functionality of the penis after complete loss of the skin and soft tissue of the penile shaft using modern biomatrices and topical negative pressure therapy.
authors.affiliation: Department of Plastic and Hand Surgery and Laboratory for Tissue Engineering and Regenerative Medicine, University Hospital of Erlangen, Friedrich-Alexander-University of Erlangen-Nuernberg, Erlangen, Germany.
authors.forename: Ingo
authors.initials: I
authors.lastname: Ludolph
authors.affiliation: Department of Plastic and Hand Surgery and Laboratory for Tissue Engineering and Regenerative Medicine, University Hospital of Erlangen, Friedrich-Alexander-University of Erlangen-Nuernberg, Erlangen, Germany.
authors.forename: Torsten
authors.initials: T
authors.lastname: Titel
authors.affiliation: Department of Plastic and Hand Surgery and Laboratory for Tissue Engineering and Regenerative Medicine, University Hospital of Erlangen, Friedrich-Alexander-University of Erlangen-Nuernberg, Erlangen, Germany.
authors.forename: Justus P
authors.initials: JP
authors.lastname: Beier
authors.affiliation: Department of Plastic and Hand Surgery and Laboratory for Tissue Engineering and Regenerative Medicine, University Hospital of Erlangen, Friedrich-Alexander-University of Erlangen-Nuernberg, Erlangen, Germany.
authors.forename: Adrian
authors.initials: A
authors.lastname: Dragu
authors.affiliation: Department of Plastic and Hand Surgery and Laboratory for Tissue Engineering and Regenerative Medicine, University Hospital of Erlangen, Friedrich-Alexander-University of Erlangen-Nuernberg, Erlangen, Germany.
authors.forename: Marweh
authors.initials: M
authors.lastname: Schmitz
authors.affiliation: Department of Urology, University Hospital of Erlangen, Friedrich-Alexander-University of Erlangen-Nuernberg, Erlangen, Germany.
authors.forename: Bernd
authors.initials: B
authors.lastname: Wullich
authors.affiliation: Department of Plastic and Hand Surgery and Laboratory for Tissue Engineering and Regenerative Medicine, University Hospital of Erlangen, Friedrich-Alexander-University of Erlangen-Nuernberg, Erlangen, Germany.
authors.forename: Raymund E
authors.initials: RE
authors.lastname: Horch
mesh_terms: D062088:Acellular Dermis; D000328:Adult; D058128:Compression Bandages; D018934:Fournier Gangrene / Q000628:therapy*; D017497:Hidradenitis Suppurativa / Q000628:therapy*; D006801:Humans; D008297:Male; D008875:Middle Aged; D054843:Negative-Pressure Wound Therapy; D010409:Penile Diseases / Q000628:therapy*; D019651:Plastic Surgery Procedures / Q000379:methods; D016038:Skin Transplantation; D013524:Surgical Flaps; D014945:Wound Healing
keywords: Dermal template; Penile; Reconstruction; Vacuum therapy