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Page 12 of 13 Mirastschijski et al. Plast Aesthet Res 2020;7:45 I http://dx.doi.org/10.20517/2347-9264.2020.44

Table 2. Summary of outcomes with midline raphe scroti artery island flap
Pros Cons
Simple surgical technique, Penile lymphedema,
sufficient perfusion due to the presence of two arteries, wound dehiscence
intact sensibility due to the presence of cutaneous nerves
Highly elastic tissue well-suited for size changes during erection Postoperative compression therapy
Restoration of micturition Bulkiness,
Rehabilitation of sexual function presence of hair
Prevention of recurrent buried penis Scrotal size reduction,
Reduction of excessive scrotal tissue orchidopexy
Neo-foreskin Contra-indication: LSC**
Recurrence due to neo-foreskin

**LSC: Lichen sclerosus et atrophicus

obliterans), a recurrence of the disease was noticed due to restoration of the moist and predisposing milieu
for this skin disease. In this particular case, a revision with partial excision of the novel flap was indicated
and the defect was covered with a skin graft.

In conclusion, the novel neurovascular MiRA island flap is well suited to reconstruct the entire penile
shaft after tissue loss with restoration of a fully sensitive cutaneous envelope. Due to its abundant vascular
perfusion via two septal arteries, it is a safe and easily performed surgical technique for a wide range of
tissue defects of the male genitalia.

DECLARATIONS
Authors’ contributions
Invention of the flap, surgical design in anatomical studies: Mirastschijski U
Surgical procedures in patients: Mirastschijski U, Schwenke C
Made substantial contributions to the conception and design of the study, performed data analysis,
interpretation and acquisition, provided administrative, technical and material support, writing the
manuscript, corrections and advice: Mirastschijski U, Schwenke C, Schwab I, Buchhorn A, Schmiedl A

Availability of data and materials
Not applicable.

Financial support and sponsorship
None.

Conflicts of interest
All authors declared that there are no conflicts of interest.

Ethical approval and consent to participate
An informed consent to participate in the study was obtained from each patient. For variation of standard
surgical procedures, no ethical approval is needed.

Consent for publication
A written informed consent for anonymous publication of photographs was obtained from each patient.

Copyright
© The Author(s) 2020.