PMC5469244_01
Prefabricated flap in the thigh
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F1
Delay of the prefabricated thigh flap was done by cutting the skin on the lateral margins and stitching back 3 weeks before proposed phalloplasty [Figure 1].
Harvested flap demonstrating the pedicle
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F2
The delayed thigh flap was dissected and isolated on one artery and 2 veins in the pedicle [Figure 2].
Harvested flap showing dimensions
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F3
The delayed flap was measuring 30 cm x 14 cm [Figure 3].
Donor area defect on forearm
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F4
The phalloplasty flap had consumed near total forearm skin except a skin bridge of 4 cm dorsally [Figure 4].
Prefabricated flap covering the donor defect
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F5
The thigh flap was temporarily stabilised with staples on the forearm and anastomosis was done with radial artery and venae comitantes [Figure 5].
Aesthetically good result of donor area
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F6
The flap could cover whole of the donor area defect without the need of skin graft [Figure 6].
Primary closure of thigh, forearm defects and newly reconstructed phallus
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F7
Meanwhile, the donor area of thigh flap was closed primarily obviating the need for skin graft in whole procedure [Figure 7].