Department of Pediatric Surgery, Faculty of Medicine, Medipol University, Nisa Hospital, Istanbul, Turkey.
Afr J Paediatr Surg. 2023 Jan-Mar;20(1):12-20. doi: 10.4103/ajps.ajps_157_21.
The most common complication of circumcision is bleeding. Monitoring bleeding by visual assessment of the diaper can cause errors due to the high absorbency of diapers. The patient may have had significant problems before the visible changes. The amount of liquid that wets the cloth does not necessarily lead to a visual change consistent with the amount, and the nature of the liquid contaminating the diaper may cause difficulties in terms of visual evaluation. Making a decision based on the visual changes in the patient's diaper cannot be considered as reliable.
We planned to evaluate the visual changes that are caused by liquids of various volumes and contents that wet the diaper, according to measurable criteria. We aimed to emphasise the importance of the subject in circumcision practices of diapered children. Wetting of diapers with different volumes and variable blood load was performed utilising blood with different haematocrits and fluids. One hundred and sixty different diapers in four groups were moistened utilising the drip method. Visual changes in the soaked diapers were evaluated with the colorimetric method and five different colour criteria. The saturation and lightness values, which indicate the colour value, were obtained by using the numerical equivalents of the three main components, red, green and blue. Analysis was carried out by subjecting statistical evaluation within and between groups.
There was a significant difference between the control group and the study group. It was observed that visual changes caused by the moistened cloths with linear increase did not make the same linear interaction. There was not a significant difference between Group II and Group IV, which were soaked with the same amount of blood and different volume of fluid. In Group III, colour saturation changes were found to have a parabolic effect instead of a linear change. In two different analyses of moistened diapers in terms of volume and blood load; it was not determined that the expected linear changes between the groups were not observed.
Visual changes in diapers related to volume or blood load effects of fluids may not be compatible with the amount of bleeding. Mistakes may occur when super absorbent wipes are used when determining the amount of bleeding from the use of colour changes in the diaper. Visual changes should not be relied on in bleeding due to circumcision. Rather, vital signs follow-up and measurable laboratory tests should be used as a basis.
包皮环切术最常见的并发症是出血。通过观察尿布来监测出血情况，由于尿布的高吸水性，可能会导致错误。患者在可见变化之前可能已经存在严重问题。浸湿尿布的液体量不一定会导致与量一致的可见变化，并且污染尿布的液体的性质可能会在视觉评估方面造成困难。基于患者尿布的视觉变化做出决策不能被认为是可靠的。
我们计划根据浸湿尿布的各种体积和内容的液体引起的视觉变化，根据可测量的标准进行评估。我们旨在强调在有尿布的儿童的包皮环切术实践中这一主题的重要性。利用不同血细胞比容和不同液体的血液对不同体积的尿布进行加湿。利用滴注法对 160 个不同的尿布进行加湿，每个尿布分成四组。使用比色法和五种不同的颜色标准评估浸湿尿布的视觉变化。通过使用三个主要成分（红色、绿色和蓝色）的数值等效物获得表示颜色值的饱和度和亮度值。通过在组内和组间进行统计评估来进行分析。
对照组和研究组之间存在显著差异。观察到，随着浸湿布线性增加引起的视觉变化没有产生相同的线性相互作用。用相同量的血液和不同体积的液体浸湿的第 II 组和第 IV 组之间没有显著差异。在第 III 组中，发现颜色饱和度变化呈抛物线效应，而不是线性变化。在根据体积和血液负荷对浸湿尿布进行的两次不同分析中；没有确定在组之间没有观察到预期的线性变化。
与液体的体积或血液负荷效应相关的尿布的视觉变化可能与出血量不相符。在确定由于使用尿布中的颜色变化导致的出血量时，使用超级吸收擦拭物可能会导致错误。在包皮环切术后出血时，不应依赖于视觉变化。相反，应将生命体征监测和可测量的实验室测试作为依据。
