Department of Pediatric Surgery, Medipol University, Faculty of Medicine, Nisa Hospital, İstanbul, Turkey.
Niger J Clin Pract. 2022 Oct;25(10):1704-1709. doi: 10.4103/njcp.njcp_187_22.
Evaluation of circumcision bleeding cannot depend on the visual change in the diaper. Diapers have different product features and absorbency capacities. The apparent changes in the diapers may vary according to their absorbent capacity and may not be in parallel with the amount of bleeding. Before significant visual difference occurs, the patient's hemodynamics may be impaired.
Aim of the study is to evaluate better circumcision bleeding.
Patients were divided into groups according to 12 different brand diapers of the same size, containing super-absorbent material. The study started by 15/01/2022, and finished by end of 01/03/2022. Diapers with concealed brands were soaked with blood with equal hematocrit value in 100 ml with increments of 5 ml. 252 images were obtained by taking 21 images of each diaper with the same method. The diapers were evaluated colorimetrically, and numerical values were obtained showing the color differences in red, green, and blue and saturation and lightness. Working groups were formed according to 12 different brands of diapers of the same size, containing super-absorbent material. Standard statistical tests were performed using obtained values.
: Dry diapers had different weights, volumes, and specific gravities; the diapers with the lowest unit weight were ranked ninth in terms of volume; the diapers with the highest specific gravity were ranked third in terms of thinness. There were significant differences in the blood on the diaper, and significant differences between some groups (p < 0.005); on the other hand, there was not any difference between some other groups (p > 0.05). There was a significant relationship in terms of Analysis of Variance (ANOVA) (P < 0.05 and P < 0.01). Visual graphic examination showed that linear but non-parallel color changes occurred. As the blood load increased, the visual and statistical differences between the diapers became more pronounced, and the curves diverged.
Visual evaluation of the color change of the diapers may not give accurate results for bleeding follow-up. If necessary to use diapers after circumcision, it is more appropriate to prefer those with low absorbency capacity. Using fabric or cotton products in cases with bleeding risk may be recommended. If bleeding is suspected, hemogram control is the most appropriate option. Diaper manufacturers should warn consumers of the risk. In conclusion, we should be on the safe side for mortality and morbidity.
评估包皮环切术出血不能仅依靠尿布外观的变化。尿布具有不同的产品特性和吸液能力。尿布的外观变化可能因其吸液能力而异，且可能与出血量不成正比。在出现明显的视觉差异之前，患者的血液动力学可能已经受损。
本研究旨在更好地评估包皮环切术出血情况。
根据相同尺寸、含有高吸水性材料的 12 种不同品牌的尿布将患者分为不同的组。研究于 2022 年 1 月 15 日开始，于 2022 年 3 月 1 日结束。将具有隐藏品牌的尿布用等血细胞比容值（100ml 中增加 5ml）的血液浸透。用相同方法对每个尿布拍摄 21 张图像，共获得 252 张图像。对尿布进行比色评估，获得红色、绿色和蓝色的色差以及饱和度和亮度的数值。根据相同尺寸、含有高吸水性材料的 12 种不同品牌的尿布组成工作组。使用获得的值进行标准统计检验。
干尿布的重量、体积和比重不同；单位重量最低的尿布在体积方面排名第九；比重最高的尿布在厚度方面排名第三。尿布上的血液有显著差异，一些组之间存在显著差异（p<0.005）；另一方面，一些其他组之间没有差异（p>0.05）。方差分析（ANOVA）显示存在显著关系（p<0.05 和 p<0.01）。视觉图形检查显示，颜色发生线性但非平行变化。随着血负荷的增加，尿布的视觉和统计差异变得更加明显，曲线发散。
仅通过观察尿布颜色变化进行评估可能无法准确反映出血情况。如果需要在包皮环切术后使用尿布，最好选择吸液能力较低的产品。对于有出血风险的病例，可能建议使用织物或棉质产品。如果怀疑出血，控制血常规是最合适的选择。尿布制造商应警告消费者相关风险。总之，我们应该谨慎行事，以降低死亡率和发病率。
