Buried penis repair with escutcheonectomy used for split thickness skin graft and wound vac placement

• The combination of negative pressure wound vac and incisional vac dressings are easily reproducible dressings for graft stabilization. • Skin graft from removed escutcheon is a feasible donor site. • Escutcheon donor site also minimizes morbidity and streamline wound care. Adult acquired buried penis (AABP) is a heterogenous disease that can have significant effects on patient’s quality of life including poor sexual function, urinary dribbling, and recurrent infections. Split thickness skin grafting after resection of diseased penile shaft skin has been used to reduce the risk of reburying and improve cosmetic outcomes in AABP. Short term complications include graft failure from hematoma or seroma formation. In this video, we describe a technique for harvesting a split thickness skin graft from the resected escutcheon as well as a wound vacuum placement technique to aid in post operative wound healing. Wound vacuum placement can be difficult on complex surfaces, and the described technique in this video is both easily reproducible and easy to troubleshoot. Further research is needed to quantify the cosmetic and functional outcomes of this approach.