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The Inner Prepuce Flap for Penile Scald Burns

Fuller, Sam M. MD*; Roughton, Michelle C. MD; Gottlieb, Lawrence J. MD

doi: 10.1097/BCR.0000000000000055
Original Articles

Preputial skin has similar color, texture, and composition to the skin of the penile shaft. The inner preputial skin may be transferred as a flap based upon Dartos fascia to resurface full-thickness burns of the penile shaft, providing a gliding and stretchable surface cover unique to the penis. The advantages of using the inner prepuce skin to resurface full-thickness burns of the penile shaft will be elucidated and the technique will be described. A retrospective chart review was performed of three patients whose penile shaft was resurfaced with inner prepuce flaps after tangential excision of their full-thickness scald burns. Patient 1 was a 9-year-old boy who sustained an 8% TBSA scald burn resulting in a full-thickness burn to the dorsum of his penis. Patient 2 was a 3-year-old boy who sustained a 60% TBSA immersion scald burn as a victim of child abuse, resulting in a circumferential penile burn. Patient 3 was an 8- year-old boy who sustained a 3% TBSA grease burn to the dorsum of his penis. The inner surface of the prepuce of the patients was intact. They were treated with an inner preputial flap. Full-thickness scald burns to the penis are unusual and challenging for the patient, family, and burn surgeon. It is advantageous that inner preputial skin is commonly spared. This specialized thin skin is ideal for resurfacing the penile shaft and should be used when available.

From the *University of Chicago Medical Center, Illinois; University of North Carolina Health Care; and Section of Plastic and Reconstructive Surgery, Department of Surgery, University of Chicago, Chicago, Illinois.

Address correspondence to Lawrence J. Gottlieb, MD, University of Chicago Medical Center, Section of Plastic and Reconstructive Surgery, 5841 S. Maryland Avenue, Chicago, Illinois 60637.

© 2014 The American Burn Association