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Penis cilt defektlerinin onarımında deri greft uygulamaları

Skin graft administration in penile skin defects

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Abstract (2. Language): 
Skin or soft tissue losses of the penis cause significant morbidity for the patient, and coverage of these defects may also pose a formidable challenge for the surgeon. In this paper results of the 9 patients treated with skin graft for penile skin defect are evaluated. Causes of the skin defect were prior surgery in 3 cases, gunshot injury in 5 cases and dermatological disorder in 1 case. Five patients who had relatively small skin loss were treated with full thickness skin graft, whereas 4 cases were treated with split thickness skin graft. Graft thickness was preferred as 0.015 inches. Meshing was not performed but a few stab incisions were done on graft to ease the drainage of particular fluid collected under the graft. Graft was sutured to the skin defect with a 4/0 chromic catgut. A specially designed sponge dressing the penis circumferentially was applied to immobilize the graft and penis. Patients were maintained on bed rest for 5 days, and dressings were changed afterwards. The ratio of graft take was 100% in the patients. The mean follow-up period was 7 months, and satisfactory cosmetic and functional results were achieved with skin graft administration.
Abstract (Original Language): 
Peniste oluşan deri ya da yumuşak doku kayıpları hasta morbiditesine yol açan önemli sorunlardan birisidir ve bu defektlerin kapatılması cerrah için de problem oluşturabilmektedir. Bu çalışmada penis cilt defekt onarımı için deri grefti uygulanan 9 hastaya ait sonuçlar değerlendirilmiştir. Üç hastada cilt defekti, önceki cerrahi girişime bağlı olarak gelişmişken, 5 hastada ateşli silah yaralanmasına bağlı, bir hastada ise deri hastalığına bağlı gelişmişti. Cilt defektinin küçük olduğu 5 hastada tam kat deri grefti kullanılırken, diğer hastalarda parsiyel kalınlıkta deri grefti kullanıldı. Bu greftler için kalınlık 0.015 “inch” olarak tercih edildi. Greftler "mesh"lenmedi, ancak greft altında birikecek sıvının drenajını sağlamak için greftte sınırlı sayıda delik açıldı. Greftler penisteki cilt defektine 4/0 krome katgüt ile sütüre edildi. Penisi ve grefti immobilize etmek için penisi çepeçevre saran özel sünger pansuman uygulandı. Hastalar 5 gün süresince yatak istirahatinde kalırken pansumanlar da bu süre sonunda açıldı. Dokuz hastada da greft tutma oranı %100'dü. Hastalar 7 ay süresince takip edildi ve bu süre sonunda fonksiyonel ve kozmetik açıdan tatmin edici sonuçlar alındı.
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