Autologous split‐thickness skin graft for penile coverage in the treatment of buried (trapped) penis after radical circumcision

.\udAbout 25% of the total world male\udpopulation is circumcised and circumcision\udremains one of the oldest and commonest\udoperations performed worldwide [ 1 – 4 ] . Over\ud30 000 operations are performed annually in\udthe UK, mostly on children [ 5 ] . The aim of\udthe procedure is to remove suffi cient\udforeskin from the penile shaft and the inner\udpreputial epithelium to uncover the glans.\udThe main factors to consider for minimising\udmorbidity are attention to asepsis, adequate\udbut not excessive excision of the foreskin,\udhaemostasis and cosmesis [ 6 ] .\udDespite the precautions, complications occur\udin 2 – 10% of cases [ 6 – 8 ] . Haemorrhage and\udsepsis are the most common. Removal of\udexcessive preputial skin can lead to an\udunsatisfactory cosmetic and functional\udresult and is considered a major cause of\udacquired buried (trapped) penis (BP).\udBP is an unusual, diffi cult-to-treat condition\udthat presents a unique challenge to the\udplastic surgeon and the urologist. Although\udno specifi c approach can be applicable to all\udpatients, a combination of various\udtechniques to tackle the problem of skin\udcoverage may be applied. Large Z-plasties,\udbased at the penopubic angle to transfer\udskin for proximal shaft coverage have been\udsuggested. However, in cases involving\udextensive penile denudation, an autologous\udsplit-thickness skin graft (STSG) to the\udpenile shaft may be indicated [ 9 ] .\udThe aim of the present manuscript is to\udprovide a step-by-step description of our\udtechnique of coverage of the penile shaft\udusing an autologous STSG of the lateral\udthigh surface