{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,28]],"date-time":"2025-10-28T15:15:15Z","timestamp":1761664515623,"version":"3.40.5"},"reference-count":33,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2022,11,23]],"date-time":"2022-11-23T00:00:00Z","timestamp":1669161600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Microsurgery"],"published-print":{"date-parts":[[2023,5]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Reconstruction of penoscrotal defects resulted from margin\u2010controlled excision of extramammary Paget's disease (EMPD) remains challenging, due to its unpredictably varying extents. The present study aimed to investigate outcomes of reconstruction of penoscrotal defects following radical excision of EMPD and to introduce a simplified algorithm for selecting reconstruction strategies.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Patients with penoscrotal EMPD who were treated with wide excision and subsequent reconstruction from 2009 to 2020 were reviewed. Their demographics, operation\u2010related characteristics, and postoperative outcomes were evaluated.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>In total, 46 patients with a mean age of 64.9\u2009years (range, 44\u201385\u2009years) were analyzed. An average size of defects was 129.6\u00a0cm<jats:sup>2<\/jats:sup> (range, 8\u2013900\u2009cm<jats:sup>2<\/jats:sup>). The most frequently involving anatomical subunit was scrotum, followed by suprapubic area and penile shaft. Twenty\u2010six patients had defects spanning multiple subunits. The most commonly used reconstruction methods for each anatomical subunit were internal pudendal artery perforator (IPAP) flaps and\/or scrotal flaps for scrotal defects, superficial external pudendal artery perforator (SEPAP) flaps for suprapubic defects, and skin grafts for penile defects. In all but four cases, successful reconstruction was achieved with combination of those reconstruction options. No major complications developed except for one case of marginal flap necrosis. All patients were satisfied with their aesthetic and functional results.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Diverse penoscrotal defects following excision of EMPD could be solidly reconstructed with combination of several loco\u2010regional options. A simplified algorithm using in combination of IPAP flap, SEPAP flap, scrotal flap, and skin graft may enable efficient and reliable reconstruction of penoscrotal EMPD defects.<\/jats:p><\/jats:sec>","DOI":"10.1002\/micr.30988","type":"journal-article","created":{"date-parts":[[2022,11,24]],"date-time":"2022-11-24T13:22:07Z","timestamp":1669296127000},"page":"316-324","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Penoscrotal defect reconstruction using loco\u2010regional flaps in treatment of extramammary Paget's disease: Experience and suggestion of a simplified algorithm"],"prefix":"10.1002","volume":"43","author":[{"given":"Woo\u2010Ju","family":"Kim","sequence":"first","affiliation":[{"name":"Department of Plastic Surgery, Chung\u2010Ang University Gwangmyeong hospital Chung\u2010Ang University School of Medicine  Seoul Republic of Korea"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Su\u2010Hwan","family":"Kim","sequence":"additional","affiliation":[{"name":"Department of Plastic Surgery, Samsung Medical Center Sungkyunkwan University School of Medicine  Seoul Republic of Korea"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hyun\u2010Hwan","family":"Sung","sequence":"additional","affiliation":[{"name":"Department of Urology, Samsung Medical Center Sungkyunkwan University School of Medicine  Seoul Republic of Korea"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9070-9296","authenticated-orcid":false,"given":"Kyeong\u2010Tae","family":"Lee","sequence":"additional","affiliation":[{"name":"Department of Plastic Surgery, Samsung Medical Center Sungkyunkwan University School of Medicine  Seoul Republic of Korea"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jai\u2010Kyong","family":"Pyon","sequence":"additional","affiliation":[{"name":"Department of Plastic Surgery, Samsung Medical Center Sungkyunkwan University School of Medicine  Seoul Republic of Korea"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2022,11,23]]},"reference":[{"key":"e_1_2_9_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.urology.2014.06.023"},{"key":"e_1_2_9_3_1","doi-asserted-by":"publisher","DOI":"10.1097\/sap.0000000000002986"},{"key":"e_1_2_9_4_1","doi-asserted-by":"publisher","DOI":"10.1002\/micr.22279"},{"key":"e_1_2_9_5_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.bjps.2019.03.016"},{"key":"e_1_2_9_6_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ejogrb.2019.08.006"},{"key":"e_1_2_9_7_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.bjps.2010.07.018"},{"key":"e_1_2_9_8_1","doi-asserted-by":"publisher","DOI":"10.1097\/scs.0000000000001093"},{"key":"e_1_2_9_9_1","first-page":"187","article-title":"Paget's disease affecting the scrotum and penis","volume":"40","author":"Crocker H. 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