Application of Autodermoplasty for Gunshot Injury of Penis and Scrotum at the Specialized Level of Medical Care (Clinical case)

Abstract

In peacetime, closed and especially open injuries of the penis are rare in military personnel. In wartime, penile injuries, mainly gunshot and combined, occur quite often. During the WWII, gunshot wounds of the penis accounted for 14% of the total number of injuries of the genitourinary organs. Damage to the penis, especially with the subsequent loss of an organ or part of it, causes not just physical struggle, but also psychological trauma. Damage to the penis accounts for up to half of all injuries of the external genital organs. The frequency of damage to the penis during military conflicts is known and ranges from 10.3 to 16.2 %, according to various authors. Specialized urological care involves the closure of large defects by skin grafts, reconstructive surgery, treatment of complications, closure of the fistula of the bladder and urethra. Mortality among patients with isolated injuries of the penis is minimal, but such patients need emergent medical care, often prompt. Clinical observation of surgical treatment with autodermoplasty of a gunshot wound of the penis at the IV level of medical care is presented. Complete healing of the soft tissue defect of the penis was observed. In order to study the effectiveness of autodermoplasty of a skin defect after a gunshot wound of the penis with a flap of skin from the hip, a dermal fragment was histologically studied after 30 days. At the border of the two fragments, marked fibrosis of the dermis, angiomatosis was noted, foci of chronic inflammation are located in the deeper layers of the dermis, along with fragments of suture material are giant multinucleated cells of the type of foreign bodies. Genital function restored, erection saved. Gunshot combat damage to the external genitalia is an urgent problem for field surgeons and urologists. Despite the improvement of personal protective equipment and the introduction of a new doctrine of medical and evacuation support, methods of prevention, primary care and longterm treatment require attention.