tailieunhanh - Urethral Reconstructive Surgery - part 7

Đánh giá trước phẫu thuật và chuẩn bị - 132 phẫu thuật Kỹ thuật - 133 đề chung của việc sử dụng đảo da Nonhirsute hoặc Epilated Onlays đề chung Sử dụng các quần đảo da dương vật - 134 sau mổ khóa học | 16 The Use of Flaps in Urethral Reconstructive Surgery . Jordan . Rourke Genital Vascular Supply - 130 Principles of Flap Anatomy - 131 Physical Characteristics of the Flap - 131 Flap Vascularity - 131 Mechanics of Elevation and Flap Transfer - 131 Surgical Procedure - 132 Preoperative Evaluation and Preparation - 132 Surgical Technique - 133 Generalities of Using Nonhirsute or Epilated Skin Island Onlays - 133 Generalities of Using Penile Skin Islands - 134 Postoperative Course - 135 Conclusions - 136 References - 136 130 Chapter 16 The Use of Flaps in Urethral Reconstructive Surgery Although excision of a strictured anterior urethral segment with primary spatulated reanastomosis is the best and most durable repair its application can be limited by the location and length of the stricture. In cases where application of this technique is limited however . severely stenotic areas totally obliterated areas proximal areas that have been hydrodilated or areas that require chronic dilation the surgeon must resort to tissue transfer techniques. This chapter discusses the principles associated with the use of genital skin islands for difficult cases of urethral reconstruction. Genital Vascular Supply To apply flap technology to urethral reconstruction the surgeon should have an excellent working knowledge of the vascular anatomy of the areas to be reconstructed and the tissues to be transferred. Although the genital blood supply is described in detail elsewhere in this text it is selectively re-emphasized in this chapter as it applies to tissue transfer for reconstructive surgery. The corpus spongiosum has a dual blood supply. The deep internal pudendal artery gives off the common perineal artery which branches to form the posterior scrotal artery and the lateral perineal artery and then extends to become the common penile artery. The proximal branches of the common penile artery