摘要目的:探讨阴囊双蒂皮瓣联合拱顶石皮瓣修复男性阴部乳房外Paget病术后大面积缺损的临床效果。方法:回顾分析2018年2月至2019年3月于江西省皮肤病专科医院收治的6例男性阴部乳房外Paget病患者的临床资料。患者年龄70 ~ 84（中位77.5）岁，病灶累及阴阜、阴茎及阴囊，术后缺损面积18 ~ 133（中位96）cm 2。所有患者阴阜部缺损选择腹部拱顶石皮瓣修复，阴囊及阴茎部缺损利用残存阴囊组织设计阴囊双蒂皮瓣修复。术后1、3个月及之后每3个月随访。 结果:6例患者随访3 ~ 36个月，平均10个月，皮瓣均成活，皮瓣色泽和质地较好，供皮区和受皮区在功能和外形上均达到良好效果。结论:阴囊双蒂皮瓣及拱顶石皮瓣联合使用可修复男性阴部乳房外Paget病切除术后大面积缺损，操作简单，血供良好。

abstractsObjective:To evaluate clinical efficacy of bipedicled scrotal flaps combined with keystone-design perforator island flaps in repairing postoperative large-area defects in male patients with extramammary Paget′s disease of the perineum.Methods:Clinical data were collected from 6 male patients with extramammary Paget′s disease of the perineum in Dermatology Hospital of Jiangxi Province from February 2018 to March 2019, and analyzed retrospectively. These patients were aged from 70 to 84 years (median, 77.5 years) , skin lesions involved the mons pubis, penis and scrotum, and the area of postoperative skin defects varied from 18 to 133 cm 2 (median, 96 cm 2) in size. In all the patients, mons pubis defects after tumor resection were repaired with abdominal keystone-design perforator island flaps, and scrotal and penile defects were repaired with bipedicled scrotal flaps using the remaining scrotal tissues. These patients were followed up at 1 and 3 months after surgery and every 3 months thereafter. Results:All the 6 patients were followed up for 3 - 36 months, with an average of 10 months. All flaps survived with a good color and texture match, and favorable function and appearance were achieved in both the donor and recipient sites.Conclusions:The bipedicled scrotal flaps combined with keystone-design perforator island flaps can repair postoperative large-area defects in male patients with extramammary Paget′s disease of the perineum. Moreover, the operation is simple, and good blood supply can be achieved.