Guinot A, Arnaud A, Azzis O, Habonimana E, Jasienski S, Frémond B
Department of Pediatric Surgery, University Hospital of Rennes, F-35000, France.
Department of Pediatric Surgery, University Hospital of Rennes, F-35000, France.
J Pediatr Urol. 2014 Apr;10(2):300-5. doi: 10.1016/j.jpurol.2013.09.026. Epub 2013 Nov 13.
Platelet-rich fibrin (PRF) has been shown to have structural and biological properties that promote tissue healing. This prospective study evaluated the feasibility, safety, and efficiency of using autologous PRF membrane for urethroplasty coverage in distal hypospadias.
We prospectively included 33 patients with distal hypospadias operated on between June 2010 and September 2011. Urethroplasties were performed using the Duplay technique. During surgery, 5-10 ml of patient's blood was collected and immediately centrifuged. A PRF clot was transformed into a dense fibrin membrane with a particular cell content and architecture. This membrane was applied and sutured over the urethroplasty. The perioperative course and complications were recorded. Outcomes were compared with those in a control group of children undergoing the same procedure, but with another mean of coverage.
With a median follow-up of 8 months (range, 6-18 months), urethral fistula occurred in 2/33 patients. No other complication was noted. No complication related to the blood sampling was reported. There was no statistically significant difference with the control group (p = 0.65).
The PRF patch seems to be a safe and efficient covering technique. Thus, procedure is an additional approach to coverage for hypospadias surgery, and may help to reduce the incidence of postoperative complications when coverage healthy tissue is not available.
富含血小板纤维蛋白（PRF）已被证明具有促进组织愈合的结构和生物学特性。本前瞻性研究评估了使用自体PRF膜覆盖远端尿道下裂尿道成形术的可行性、安全性和有效性。
我们前瞻性纳入了2010年6月至2011年9月间接受手术的33例远端尿道下裂患者。采用杜普莱（Duplay）技术进行尿道成形术。手术过程中，采集患者5 - 10毫升血液并立即离心。将PRF凝块转化为具有特定细胞成分和结构的致密纤维蛋白膜。将该膜应用并缝合于尿道成形术上。记录围手术期过程及并发症。将结果与接受相同手术但采用另一种覆盖方式的儿童对照组进行比较。
中位随访8个月（范围6 - 18个月），33例患者中有2例发生尿道瘘。未观察到其他并发症。未报告与采血相关的并发症。与对照组相比无统计学显著差异（p = 0.65）。
PRF补片似乎是一种安全有效的覆盖技术。因此，该方法是尿道下裂手术覆盖的一种额外途径，并且在无法覆盖健康组织时可能有助于降低术后并发症的发生率。
