Scapular Of The Clinical Application Of Free Flap To Create A Penis And Urethra Hypospadias Incidence Of Gene Mutations

In 1936, Bargoras' success in phallus reconstruction using abdominal tubular flap was the first time success in phallus reconstruction of medical history. The surgical technique of phallus reconstruction has been progressing rapidly and the reported methods have reached more than 30. But the results of constructive penile isn't very satisfactory at present . The ideal phallus reconstruction is still a difficult challenge of reconstructive surgeons .The techniques of phallus reconstruction can be divided into classical and modern methods . The classical methods of penile reconstruction is characteristic of using tubular flap , arbitrarily flap or perineal local flap , which were the dominant methods of phallus reconstruction from 40s to 70s of 20th century, for example : Belly tubular flap, middle abdominal flap, inside thigh cutaneous or musculo-cutaneous flap and scrotal flap. After 1980, the modern methods of penile reconstruction have become main methods with the characteristics of using axial flaps, which advanced the techniques from experiential age to rationally age, for example : island skin flap, free flap and composite flap . The modern techniques of phallus reconstruction emphasize three aspects: 1. operative simplification ; 2. enough blood supply ; 3. creating sensation . Many free flaps have been reported for phallus reconstruction, the influential methods were those techniques : 1. arm flap; 2. lateral upper arm flap; 3. tensor fasciae latae muscle musculo-cutaneous flap; 4. latissimus dorsi musculo-cutaneous flap; 5. slender muscle musculo-cutaneous flap ; 6. deltoid muscle musculo-cutaneous flap; 7. fibula osseous-cutaneous flap.Free scapular flap transfer for the penis reconstruction is a new method in phallus reconstruction, which was brought forward by professor Senkai Li , and there is no any analogic method been reported at present. The method transferring free scapular flap for phallus reconstruction, which is supplied by unilateral circumflex scapular artery and veins, is a good operative technique with the characteristics of operating conveniently, high rate of success and good configuration of constructive penile . But the constructive penile is too large for a fat case and could only recover a part of sensation as the anatomy of sensorial nerve is difficult.We have reconstructed 4 penises using the free scapular flap combined shoring prosthesis of silica gel stick contained silver thread from June 2000 to Feb 2002. The...