Complex genital trauma (case report)

Abstract

Clinical case description: an 8-year-old male patient with severe genital trauma with exposure and loss of skin on the scrotum, penis, and lower abdomen, leaving the testes uncovered. At the secondary level of care, the testes were hidden in the inguinal region, and a thin skin graft was placed on the shaft of the penis without cellular tissue, which caused distal penile lymphedema. Our management consisted of an initial orchidopexy, followed by the placement of an abdominal skin expander to obtain skin with adequate lymphatic drainage. Finally, a pedicled full-thickness skin flap was created to cover the penis, achieving a functional and aesthetic result.

Relevance: external genital trauma in children is a rare condition, accounting for 0.6 % of cases.

Clinical implications: this case demonstrated that a stepwise reconstructive approach with a skin expander and pedicled full-thickness skin flap restored genital function and aesthetics in a complex pediatric genital trauma.

Conclusions: initial orchidopexy and the use of a skin expander and a pedicled full-thickness skin flap allowed adequate restoration of lymphatic drainage, obtaining functional and aesthetic results.