Textbook of Penile Cancer by Asif Muneer & Simon Horenblas

Author:Asif Muneer & Simon Horenblas
Language: eng
Format: epub
Publisher: Springer International Publishing, Cham

The thickness of the graft can easily be chosen when using the air dermatome. Typically, 0.012 in. – 0.016 in. grafts are used for glans reconstruction during glansectomy or glans resurfacing procedure.

The SSG may either be placed as a sheet of skin or fenestrated with a blade or meshed using a mesher device and a graft carrier with different skin ratios ranging from 1:1 to 6:1 to increase the surface area for wound cover. Skin ratios of 1:1 or 1.5:1 are used to cover the majority of wounds as higher ratios make the graft very fragile. Placing the graft as a sheet gives a better cosmetic outcome, but fenestrations reduce the risk of a haematoma developing and preventing graft take. SSGs are susceptible to secondary graft contraction and this must always be taken into account.

To secure the graft onto a defect, glue, sutures or even staples may be used. Once secured the dressings consist of a non-adherent layer with overlying wet and dry gauze and an outer adherent layer to prevent shear. The graft “take” is checked at 2–5 days. The donor site can be covered with a simple dressing usually in the form of Kaltostat®, gauze and Mefix® and these remain in place until the wound has re-epithelialised at 14 days.

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