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Experience with specially designed pored polyacetal mold dressing method used in McIndoe-style vaginoplasty.

Authors
  • Han, So-Eun1
  • Go, Ju Young2
  • Choi, Doo Seok3
  • Seo, Gi Hong4
  • Lim, So Young5
  • 1 Department of Plastic and Reconstructive Surgery, Ilsan Paik Hospital, Inje University, Goyang, Republic of Korea. , (North Korea)
  • 2 Department of Plastic Surgery, Samsung Medical Center, Sungkyunkwan University, School of Medicine, Seoul, Republic of Korea. , (North Korea)
  • 3 Department of Obstetrics and Gynecology, Samsung Medical Center, Sungkyunkwan University, School of Medicine, Seoul, Republic of Korea. , (North Korea)
  • 4 Department of Biomedical Engineering, Samsung Medical Center, Sungkyunkwan University, School of Medicine, Seoul, Republic of Korea. , (North Korea)
  • 5 Department of Plastic Surgery, Samsung Medical Center, Sungkyunkwan University, School of Medicine, Seoul, Republic of Korea. Electronic address: [email protected] , (North Korea)
Type
Published Article
Journal
Journal of pediatric urology
Publication Date
Dec 01, 2017
Volume
13
Issue
6
Identifiers
DOI: 10.1016/j.jpurol.2017.05.014
PMID: 28711548
Source
Medline
Keywords
Language
English
License
Unknown

Abstract

Appropriate postoperative care and prolonged use of the mold are prerequisites for achieving successful results in McIndoe-style vaginoplasty. We introduce a specially designed pored polyacetal mold to maintain the reconstructed vagina, with favorable long-term results allowing drainage of the serous and bloody discharge without removal of the mold, and reduction of infection rate and the chance of skin graft shearing in McIndoe vaginoplasty. We retrospectively reviewed data of 10 consecutive patients with Mayer-Rokitansky-Kuster-Hauser syndrome who underwent McIndoe vaginoplasty between March 2010 and January 2014. We used a specially designed pored polyacetal mold (Figure) in all reconstructed vaginal wounds. The anatomical surgical success was evaluated by physical examination and functional success, which was defined as satisfaction with sex evaluated by patient self-assessed questionnaire. The follow-up period ranged from 1 to 3.5 years. The postoperative mean vaginal length was 9.5 cm in nine patients who used the mold regularly. In all cases in which a pored polyacetal mold was used, skin engraftment was successfully maintained without partial skin graft loss or infection. The subjective patient self-assessed satisfaction evaluation reported a high satisfaction rate. The multi-holed polyacetal vaginal mold was designed to perform vaginal irrigation without removal of the mold, allowing drainage of the serous and bloody discharge. This makes it possible to reduce infection rate and maintain successful skin engraftment by reducing the chance of skin graft shearing. The characteristics of polyacetal make it useful as a vaginal mold material as it is lightweight to use, easy to manufacture in accordance with the dimensions of the neovaginal space, and cost-effective. Although a constant follow-up evaluation is required, the pored polyacetal mold is an attractive vaginal mold dressing material to maximize the initial graft uptake, and it can be individually tailored in patients undergoing McIndoe-style vaginoplasty. The specially designed vaginal mold made up of pored polyacetal is a proper vaginal mold, which could maximize the initial graft uptake, decrease the risk of wound infection, and, therefore, decrease contracture of the neovagina in patients undergoing McIndoe vaginoplasty. Copyright © 2017 Journal of Pediatric Urology Company. Published by Elsevier Ltd. All rights reserved.

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