Penile skin necrosis: A case report of a rare complication associated with simultaneous circumcision utilizing a disposable circumcision suture device and genital beading surgery.

Background: Male circumcision is a widely performed procedure globally and is generally safe. However, penile skin necrosis is a rare but serious complication. To our knowledge, this is the first case report describing the management of complications arising from circumcision using a disposable circumcision suture device (DCSD) performed simultaneously with a genital beading procedure.

Methods: A healthy 37-year-old man underwent circumcision using a DCSD and a genital beading procedure by an unlicensed practitioner. Methods: Wound infection with skin necrosis over the penile shaft.

Results: The patient required surgical debridement and single-stage reconstruction with a local flap. After appropriate surgical intervention and antibiotic treatment, the wound healed well. No structural or functional abnormalities were noted during outpatient follow-up. Ethical approval was waived due to case report only. Informed consent was given.

Conclusions: Although the DCSD offers benefits such as reduced operative time and improved cosmetic outcomes compared with conventional circumcision, combining the procedure with genital beading is not recommended due to the increased risk of complications. There are many techniques for reconstructing penile skin loss including split-thickness skin grafts, spiral flap, rotational skin flaps, pedicled skin grafting with vascular anastomosis, etc. Complex reconstruction is not always necessary; single-stage reconstruction with a local flap is a relatively simple but effective approach in certain situations.