Animals ; Colon ; pathology ; Dogs ; Female ; Graft Survival ; Intestinal Mucosa ; pathology ; transplantation ; Mouth Mucosa ; pathology ; transplantation ; Reconstructive Surgical Procedures ; Urethra ; surgery

OBJECTIVETo investigate the reconstruction of 1/4 defect on upper-lip vermilion with a lower-lip vermilion compound tissue flap pedicled at oral commissure.

METHORDSAt the first stage, the lower lip mucosal flap pedicled by inferior labial artery was transposed to reconstruct the defect on upper lip vermilion and tubercle. The defect at the donor site was closed directly. At the second stage, the flap pedicle was cut off and revised.

RESULTS6 patients were treated with satisfactory aesthetic results. All the flaps survived completely. The oral commissure kept normal with no obvious scar at the donor sites.

CONCLUSIONSThe modified crosslip vermilion flap pedicled at oral commissure has the advantages of avoiding inconvenience in feeding, speaking and cleaning. The procedure is simple with available blood supply. Both aesthetic and functional results are satisfactory.

Arteries ; Esthetics ; Humans ; Lip ; surgery ; Mouth Mucosa ; transplantation ; Surgical Flaps ; blood supply ; Transplant Donor Site ; surgery

Tubularized graft urethroplasty fails largely because of inadequate graft take. Prefabrication of buccal mucosa lined flap has theoretical indications for constructing neourethra with an independent blood supply. The efficacy of using a tissue expander capsule as an induced vascular bed to prefabricate an axial vascularized buccal mucosa-lined flap for tubularized urethral reconstruction in a rabbit model was tested. The experiments were performed in three stages. First, silicone tissue expanders were inserted into the groin to induce vascularized capsule pouch formation. Next, buccal mucosa grafts were transplanted to the newly formed capsular tissue supplied by the axial vessel for buccal mucosa-lined flap prefabrication. Then, circumferential urethral defects were created and repaired by buccal mucosa graft (Group 1), capsule flap (Group 2) and prefabricated capsule buccal mucosa composite flap (Group 3). With retrograde urethrography, no rabbits in Group 1 maintained a wide urethral caliber. In Group 2, the discontinued epithelial layer regenerated at 1 month, and the constructed neourethra narrowed even though the lumen surface formed intact urothelial cells at 3 months. In Group 3, buccal mucosa formed the lining in the neourethra and kept a wide urethral caliber for 3 months. The capsule may serve as an induced vascular bed for buccal mucosa-lined flap prefabrication. The prefabricated buccal mucosa-lined flap may serve as a neourethra flap for circumferential urethral replacement.
Animals ; Male ; Models, Animal ; Mouth Mucosa/transplantation* ; Rabbits ; Plastic Surgery Procedures/methods* ; Urethra/surgery*

OBJECTIVETo investigate the indications and clinical effect of using oral mucosa as the graft in hypospadias repair.

METHODSWe performed hypospadias repair using oral mucosa for 19 patients, 10 with the urethral opening at the root of the penis, 7 at the scrotum and 2 at the perineum. Of these patients, 8 had received urethroplasty once, and 6 twice, unsuccessfully, and 7 of them were complicated by penile chordee. The lower lip mucosa was used as the graft for 14 cases, and the buccal mucosa for the other 5. Fifteen cases received autologous oral mucosa onlay for repair, with the new urethra covered by the dartos coat of the dorsal skin. For the other 4 cases, whose urethral plates had been damaged in the previous operations, oral mucosa strips were used to substitute the urethral plates to get the penis straightened, followed by urethroplasty 6 months later.

RESULTSOf the 19 patients, 17 (89.5%) achieved satisfactory results, with a desirable shape of the penis and a vertical slit-like meatus at the tip of the glans. Chordee was corrected in all the patients. No urethral stricture was found during the 3 - 18 months follow-up. Urethral fistula occurred in 2 cases because of infection, but cured by surgical repair 6 months later.

CONCLUSIONUsing oral mucosa as the graft is an effective surgical option for hypospadias repair.

Adolescent ; Child ; Child, Preschool ; Humans ; Hypospadias ; surgery ; Male ; Mouth Mucosa ; transplantation ; Reconstructive Surgical Procedures ; Skin Transplantation ; Surgical Flaps ; Young Adult

OBJECTIVETo evaluate the clinical results of the replacement of plaque by buccal mucosa in the treatment of Peyronie's disease.

METHODSWe performed surgical replacement of the plaque by free autograft of buccal mucosa on 27 patients with Peyronie's disease, ranging in age from 24 to 72 years (mean 53), varying in disease course between 1 and 13 years, with a penile curvature angle of 30 degrees - 80 degrees in erection. Of the total number, 15 patients had the plaque located in the dorsal root, 6 in the dorsal shaft, 3 in the subcoronal shaft and 3 in the ventral shaft of the penis; 24 had 1 plaque, 2 had 2 and 1 had 3, ranging in size from 0.7 cm x 0.7 cm to 1.6 cm x 1.0 cm.

RESULTSSatisfactory results were achieved in all the cases, with no such complications as hematoma, infection, oral numbness, and tightness of the mouth. Of the 24 cases that were followed up for 0.5 to 7 years, complete straightening of the penis was achieved in 21, slight residual curvature (< 15 degrees) was noted in 3, a little shortening of the penis (< 1 cm) in 2, and erectile pain in 3.

CONCLUSIONBuccal mucosa, with a stable elasticity and no shrinkage, can be recommended for wide use in the surgical treatment of Peyronie's disease.

Adult ; Aged ; Follow-Up Studies ; Humans ; Male ; Middle Aged ; Mouth Mucosa ; transplantation ; Penile Induration ; pathology ; surgery ; Penis ; pathology ; Transplantation, Autologous

Humans ; Male ; Middle Aged ; Mouth Mucosa ; transplantation ; Reconstructive Surgical Procedures ; methods ; Transplantation, Autologous ; Urethra ; surgery ; Urethral Stricture ; surgery

OBJECTIVETo evaluate the clinical effect of acellular dermal matrix allograft in repairing the oral mucosal defect of immediate implant.

METHODS51 cases underwent immediate implant surgery for 67 implants right after the teeth or roots extracted. The mucosal defect of implant areas were repaired by acellular dermal matrix. The basal membrane side of acellular dermal matrix was exposed to oral cavity, and another side was attached to the implant and alveolar crest surface. It was intercalated between mucosal flap and alveolar and fixed by iodoform pack or base plate. To understand condition of wound healing the patients were followed up from 4 months to 6 months after operation. The acellular dermal matrix closed wound and histological changes were observed. The implant was followed up months to 4 years.

RESULTSThe wounds were completely healed in 54 implant areas, partially healed in 11 implant areas, not healed 2 implant areas. histological examination wasn't differentiation between mucous epithelium and graft epithelium. None of 67 implants showed deterioration in the follow-up of one year. It was no obvious sign of immune rejection.

CONCLUSIONThe clinical result of acellular dermal matrix in repair the mucosal defect of immediate implant is good, the advantages are not to affect the integration bone with implant, less operation trauma, good esthetics results.

Adolescent ; Adult ; Aged ; Dental Implantation ; methods ; Dermis ; transplantation ; Female ; Humans ; Male ; Middle Aged ; Mouth Mucosa ; surgery ; Tissue Transplantation ; Transplantation, Homologous ; Transplants ; Wound Healing ; Young Adult

OBJECTIVETo report the treatment of serious hypospadias in adults with free graft of tubed mouth mucosa and scrotal fascia flaps.

METHODSThe tubed mouth mucosa was free grafted to fabricate the distal segment of urethra. It was anastomosed to the urethra at the second stage. The scrotal fascia flap was used to cover the penile wound. The biggest flap was 3 cm in width and 6.5 cm in length.

RESULTSFrom Jan. 2002 to Dec. 2007, 76 adults with severe hypospadias were treated. Infection happened in 4 cases. 2 cases had urethral fistula due to the partial flap necrosis which was healed automatically within 2-4 weeks. All the other patients healed primarily.

CONCLUSIONSIt is a good method for the treatment of serious hypospadias in adults with scrotal fascia flaps and free graft of tubed mouth mucosa which is anastomosed to the urethra at the second stage.

Adolescent ; Adult ; Anastomosis, Surgical ; Humans ; Hypospadias ; surgery ; Male ; Middle Aged ; Mouth Mucosa ; transplantation ; Reconstructive Surgical Procedures ; methods ; Scrotum ; transplantation ; Skin Transplantation ; Surgical Flaps ; Young Adult

OBJECTIVETo evaluate the clinical effect of acellular dermal matrix allograft in repairing the defect of oral mucosa.

METHODSForty-two cases of large superficial defects in oral cavity were repaired by acellular dermal matrix. Defect areas included vestibule, tongue, the floor of mouth, buccal mucosa, palate, gingival and lip. Defect size was between 2.25 cm(2) and 12 cm(2). The basement membrane side of acellular dermal matrix was exposed to oral cavity, and another side was attached to the surgical wound surface. It was fixed by suture, reverse strapping and prepared template to overlaid large superficial defect of oral mucosa. The patients were followed up from 3 months to 1 year after operation.

RESULTSThe wounds were completely healed in 40 cases, partially healed in 2 cases. There was no failure case. The healing was divided into two types: epithelialization healing pattern in 12 cases, attached healing pattern in 30 cases. Contraction of grafts occurred at 2 - 4 weeks. The contraction rate was 3.7% +/- 1.1% at fourth week. Scarring did not appear.

CONCLUSIONThe clinical result of acellular dermal matrix allograft in repair the defect of oral mucosa is good. Acellular dermal matrix can be taken as a substitute to autograft of skin.

Adult ; Aged ; Dermis ; cytology ; transplantation ; Extracellular Matrix ; transplantation ; Female ; Follow-Up Studies ; Humans ; Male ; Middle Aged ; Mouth Mucosa ; pathology ; surgery ; Transplantation, Homologous

Tissue transfer techniques are an essential part of the reconstructive urologist's armamentarium. Flaps and graft techniques are widely used in genital and urethral reconstruction. A graft is tissue that is moved from a donor site to a recipient site without its native blood supply. The main types of grafts used in urology are full thickness grafts, split thickness skin grafts and buccal mucosa grafts. Flaps are transferred from the donor site to the recipient site on a pedicle containing its native blood supply. Flaps can be classified based on blood supply, elevation methods or the method of transfer. The most used flaps in urology include penile, preputial, and scrotal skin. We review the various techniques used in reconstructive urology and the outcomes of these techniques.
Genitalia/surgery ; Humans ; Mouth Mucosa/transplantation ; Reconstructive Surgical Procedures/*methods ; Skin Transplantation/methods ; *Surgical Flaps ; Tissue Transplantation/*methods ; Ureter/surgery ; Urethra/surgery ; Urologic Surgical Procedures/*methods