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 sec-ond 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 cir-cular 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 graft-ing 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.