title: Scrotal dartos-fascio-myo-cutaneous flaps for penis elongation after catastrophic iatrogenic skin shaft sub-amputation: A case of recovery using an extremely adaptable flap.
abstract: BACKGROUND
  Genitalia are linked to self-esteem and male sexual identity, especially among young men, who sometimes require a surgical procedure to acquire more confidence. Among the surgical procedures requested for aesthetical purposes, circumcision is one of the most popular. Although it can be considered to be a simple surgical practice, it may cause severe complications such as penile skin necrosis.
  
  
  METHODS
  We report a case of a catastrophic situation after a circumcision performed on a 27-year-old HIV positive man resulted in a drastic reduction in the length of the penile shaft due to extensive skin loss; this was subsequently restored using dartos-fascio-myo-cutaneous flaps. Primary healing occurred in 10days. No infection, dehiscence or flap ischemia were reported. Donor site morbidity was minimal. An adequate aesthetical appearance and satisfactory functional results were obtained.
  
  
  CONCLUSIONS
  Various techniques are available for penile skin covering, such as skin grafts or cutaneous flaps. The skin of the scrotum seems to be the most suitable tissue to be used to reconstruct the skin covering of the shaft as it is the most similar. Dartos-fascio-myo-cutaneous flap is a single stage procedure that is easy and safe to perform. It can provide satisfactory cosmetic and functional results, offering a large amount of tissue, with minimal donor site morbidity.
authors: Plastic and Reconstructive Microsurgery, Careggi Universital Hospital, Florence, Italy. Electronic address: innocentialessandro@alice.it.
authors: Alessandro
authors: A
authors: Innocenti
authors: Plastic and Reconstructive Microsurgery, Careggi Universital Hospital, Florence, Italy.
authors: Sara
authors: S
authors: Tanini
authors: Plastic and Reconstructive Microsurgery, Careggi Universital Hospital, Florence, Italy.
authors: F
authors: F
authors: Mori
authors: Plastic and Reconstructive Microsurgery, Careggi Universital Hospital, Florence, Italy.
authors: D
authors: D
authors: Melita
authors: Plastic and Reconstructive Microsurgery, Careggi Universital Hospital, Florence, Italy.
authors: M
authors: M
authors: Innocenti
keywords: Case report; Dartos-fascio-myo-cutaneous flaps; Penile elongation; Penile reconstruction; Penis; Penis flap; Scrotal flap