Penile Skin / Shaft Reconstruction
Penile shaft resurfacing after Fournier's gangrene, lichen sclerosus, oncologic resection, zipper injury, or circumferential avulsion uses split-thickness or full-thickness skin grafts, scrotal flaps, or groin flaps depending on graft-bed quality and the extent of the defect.
Indications
| Indication | Typical reconstruction |
|---|---|
| Fournier's / necrotizing soft-tissue loss | STSG for broad shaft resurfacing; scrotal or regional flaps when graft bed is poor |
| Lichen sclerosus with skin loss | Excision of diseased skin with graft or local flap coverage |
| Circumferential avulsion / degloving | STSG or FTSG depending bed, size, and contraction tolerance |
| Paraffin / foreign-body granuloma excision | Staged or single-stage skin replacement, sometimes with scrotal tunnel or flap techniques |
| Oncologic shaft-skin resection | Primary closure, graft, or flap based on defect size and tension |
Technique Overview
This page is a launch pointer to the dedicated shaft-reconstruction pages. For graft technique, see Penile Skin Grafting, STSG, and FTSG. For local flap options, see Muranyi Scrotal Tunnel Flap, Staged Scrotal Flap, and Penile Tissue Substitutes.
Core principles: remove all nonviable or diseased skin, preserve Buck's fascia when possible, obtain hemostasis before grafting, avoid circumferential constriction at the corona or base, and choose graft thickness based on take versus contraction.
Outcomes
Report graft take, contracture, penile curvature or tethering with erection, sensation, recurrent disease, wound infection, need for revision, and patient-reported appearance / sexual function. STSG is efficient for large resurfacing but contracts more than FTSG; FTSG has better texture and less secondary contraction but needs a better vascular bed and has limited donor size.