Single-Stage Penile Resurfacing for Foreign Body Granuloma: A Simplified Negative Pressure Wound Therapy-assisted Protocol With Dermal Substitute - 29/04/26

Doi : 10.1016/j.urology.2026.04.013

Daihun Kang ^a,^b,^{^{†
These authors contributed equally to this work as co-first authors.}}, Seung Eun Hong ^a,^b,^{^{†
These authors contributed equally to this work as co-first authors.}}, Youn Hwan Kim ^c,^⁎

^a College of Medicine, Ewha Womans University, Seoul, Republic of Korea

^b Department of Plastic and Reconstructive Surgery, Ewha Womans University Seoul Hospital, Seoul, Republic of Korea

^c Department of Plastic and Reconstructive Surgery, College of Medicine, Hanyang University, Seoul, Republic of Korea

^⁎ Address correspondence to: Youn Hwan Kim, M.D., Ph.D., Department of Plastic and Reconstructive Surgery, College of Medicine, Hanyang University, 222-1 Wangsimni-ro, Seongdong-gu, Seoul 04763, Republic of Korea. Department of Plastic and Reconstructive Surgery, College of Medicine, Hanyang University 222-1 Wangsimni-ro, Seongdong-gu Seoul 04763 Republic of Korea

Sous presse. Épreuves corrigées par l'auteur. Disponible en ligne depuis le Wednesday 29 April 2026

ABSTRACT

Objective

To present a simplified single-stage protocol using negative pressure wound therapy (NPWT) combined with dermal substitute and split-thickness skin graft (STSG) for penile foreign body granuloma resulting from subcutaneous injection of various substances.

Methods

A retrospective review was conducted on 11 consecutive patients who underwent penile resurfacing for foreign body granuloma between March 2018 and June 2025. All patients received complete excision of granulomatous tissue, Matriderm Flex application, STSG, and NPWT (−125 mmHg). Primary outcomes included graft take rate, complications, hospital stay, and patient satisfaction assessed by a 9-item questionnaire.

Results

Median patient age was 55.0 years (IQR: 51.5-58.0). Foreign body types included Vaseline alone (n = 6), Vaseline with hyaluronic acid (n = 1), hyaluronic acid alone (n = 1), and unknown fillers (n = 3). The first dressing change was performed on postoperative day 5 with near-complete graft take achieved in 10 of 11 cases (90.9%). Complications included partial graft loss with hematoma requiring evacuation (n = 1) and chronic discharge from remnant filler material (n = 1). Median satisfaction score was 37.0/45 (IQR: 36.5-39.0). Median follow-up was 18.0 months (IQR: 12.0-24.0).

Conclusion

NPWT-assisted single-stage reconstruction using dermal substitute and STSG provides a simple, reliable, and reproducible option for penile foreign body granuloma, avoiding complex flap surgery while achieving excellent graft take and high patient satisfaction.

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