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Objectives To report the outcomes of graft take and wound healing in the first reported series in which fibrin sealant was used as a tissue glue in the reconstruction of complex genital skin loss. Methods Between July 2001 and July 2005, 18 men requiring complex genital reconstruction underwent repair by two surgeons at our medical centers. Skin graft reconstruction was required in 6 men. Complete scrotal disassembly with extensive scrotal or thigh flaps was required for reconstruction of 12 others. In the skin graft cases, a thin layer of dilute fibrin sealant was sprayed on the recipient site immediately before graft apposition. In flap cases, fibrin sealant was injected beneath the flap to promote tissue adherence and prevent fluid accumulation. All wounds were followed up postoperatively and observed for evidence of graft take, seroma or hematoma formation, drainage, and infection. Results The 6 skin graft patients required a total of nine split-thickness skin grafts, all of which had 100% take. Of the 12 patients requiring flap reconstruction, 11 had excellent results. One flap case had a partial wound breakdown, but this reconstruction was performed immediately subsequent to a significant debridement and irrigation procedure in the same setting. Overall, 17 (94.4%) of 18 patients had no wound infection, seroma, hematoma, or other complications. Conclusions Fibrin sealant performs very well as a tissue glue and appears to be a useful adjunct in cases of complex genital skin loss reconstruction.

Nitrofurantoin sodium and nitrofurazone in certain critical concentrations have the ability to cause sperm immobilization. Intraoperative vas irrigation with these solutions in 24 patients has produced sterility in the immediate postoperative period. This irrigation procedure adds little time to the standard vasectomy and can easily be performed as an in-office procedure. This minimizes time-consuming postoperative sperm analyses. Moreover, in underdeveloped countries where postoperative follow-up is more difficult to obtain, this procedure would provide an additional positive factor in an attempt to insure sterility.