Purpose: To evaluate the role of micro-sized (2-3 mm) peno-preputial incisions (PPIs) in reduction of post-operative peno-preputial edema (PPE) following hypospadiac urethroplasties. Patients and methods: Between 2001-2006, 30 patients (n=15 degloved penile skin, n=5 edematous Byer's flaps, n=3 re-constructed prepuce and n=7 more than 1 cm wide mucosal collar) were tried for micro-sized (2-3 mm) PPIs which were made 0.5-1 cm apart from each other, all round along the long axis of the under lying vessels of peno-preputial skin. The depth of incisions varied from skin deep to skin-dartos deep. Results: The micro-sized PPIs effectively controlled early as well as late post-operative PPE. The PPIs healed within 7-10 days without any complications. Conclusion: PPIs can be made safely without potentiating any per or post-operative complication. These incisions reduce PPE and shorten post-operative period for subsequent surgical procedures by promoting early softening, suppling and maturation of the dissected tissues. Introduction Peno-preputial edema (PPE) quite frequently results following penile burn, trauma, extravasation of fluid, infection and strangulation. Under certain circumstances like hematomas and contusions in the degloved penile skin, prolonged surgery in complex and crippled hypospadiac, construction of wide circum-coronal mucosal collar, preputioplasty and ventralized Byer's flaps, the post-operative PPE becomes severe, prolonged (3 weeks -6 months) and frightening to the patients, parents and surgeons for fear of tension over suture lines, delayed healing, wound dehiscence, infection, fibrosis, difficulty in micturition and discomfort in wearing undergarments. In prolonged persistence of edema, the subsequent surgical procedures may have to be postponed for more than 6 months to a year till adequate tissue revascularization is established for safer dissection, better suture holding and faster wound healing. Patients and Methods In 30 patients (n=15 degloved penile skin had scattered haematomas and contusions, n = 5 edematous ventralized Byer's flaps, n = 3 re-constructed prepuce and n = 7 more than I cm wide and edematous mucosal collar), micro-sized (2-3 mm) peno-preputial incisions (PPIs) of variable depth, i.e., either up to the full thickness of peno-preputial skin (Fig. 1, n = 15 to relieve edema only) or in to the full thickness of peno-preputial skin and underlying dartos fascia (Fig. 2, n = 15 to expose haematomas and contusions) were made 0.5-1 cm apart from each other all round along the long axis of underlying vessels of peno-preputial skin.
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