Abstract: Objective: To investigate the clinical effect of self-made external support in total penile skin grafting for the repair of large skin defect after Mohs surgery. Methods: The survival rate of skin in 17 cases with extramarammy Paget's disease treated with Mohs surgery in our hospital from January 2022 to December 2023 were retrospectively analyzed. Results: Of 17 patients, 12 patients were treated with external support, of which 10 patients were healed primarily and the graft completely survived, and 2 patients were healed by second intention after partial necrosis of the skin margin at the root of the penis. A total of 5 patients were treated with conventional packing method, of which 3 patients were healed primarily, 1 patient was healed by second intention after partial necrosis of the ventral penis skin, and 1 patient was healed by second intention after circular necrosis of the penis root skin. After 6 to 24 months of follow-up, there was no recurrence of tumor, and the satisfaction rate of penile morphology and function of patients using external support was higher than that of patients using conventional packing method. Conclusion: Self-made external support in total penile skin grafting can significantly improve the survival rate of free skin transplantation, and provide a simple and effective method for the repair of large defects of the extramarammy Paget's disease.

Key words: extramarammy Paget's disease, penile skin grafting, external support