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目的总结撕脱皮肤反取皮回植重建阴囊治疗阴囊皮肤完全撕脱伤的疗效,探讨该方法修复后对生精功能的影响。方法 2001年6月-2010年6月,对8例阴囊皮肤完全撕脱伤患者行撕脱皮肤反取皮回植修复重建阴囊。年龄22～64岁,平均29岁。致伤原因:机器绞伤4例,家畜攻击致伤3例,交通事故伤1例。伤后至入院时间为1～7 h,平均3.5 h。伴阴茎皮肤撕脱伤5例,会阴处部分撕裂伤3例,睾丸、精索均外露,无明显挫伤;伴大腿皮肤撕脱伤1例。结果术后10 d拆包时观察皮片成活80%～95%,再造阴囊有挛缩迹象、不下垂,经换药后创面均Ⅰ期愈合。术后8例均获随访,随访时间12～24个月,平均16个月。末次随访时,患者阴囊松弛下垂,阴茎勃起正常。精液质量分析示:精液量2～6 mL,平均4.2 mL;精液完全液化,液化时间为15～30 min,平均23 min;精子密度为(12～27)×106/mL,平均16×106/mL;精子活率45%～65%,平均56%。精子活力A级占25%～42%,平均32%。结论撕脱皮肤反取皮回植可较好重建阴囊,修复阴囊皮肤完全撕脱伤,同时对生精功能无明显影响。
Objective To summarize the curative effect of total skin avulsion of scrotum skin treated with avocado skin remodeling and replantation scrotum and to explore the effect of this method on the function of spermatogenesis. Methods From June 2001 to June 2010, 8 patients with complete avulsion of the scrotum skin were treated with avulsion of the skin and replanted skin to repair the scrotum. Aged 22 to 64 years old, average 29 years old. Causes of injury: 4 cases of machine screw wounding, 3 cases of animal attack and injury, traffic accident in 1 case. Injury to admission time of 1 ~ 7 h, an average of 3.5 h. There were 5 cases of avulsion of the penis with skin of the penis, 3 cases of laceration of the perineum, 3 cases of testis and spermatic cord were all exposed without obvious contusion, and 1 case of avulsion of the thigh with skin. Results 10 days after unpacking survival of the skin observed 80% to 95%, reconstruction of the scrotum contracture signs do not sag, the dressing after the first phase of healing. All patients were followed up for 12-24 months (average 16 months). At the final follow-up, the patient had sagging scrotum and normal penile erection. The semen quality analysis showed that the semen volume was 2 ~ 6 mL with an average of 4.2 mL. The semen was completely liquefied with a liquefaction time of 15 ~ 30 min (average 23 min). The sperm density was (12-27) × 106 / mL with an average of 16 × 106 / mL; sperm motility 45% ~ 65%, an average of 56%. A grade sperm motility 25% to 42%, an average of 32%. Conclusions The avulsion of the skin with reverse skin graft can reconstruct the scrotum better and repair the completely avulsion of the scrotal skin with no significant effect on the function of spermatogenesis.