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尿道下裂修复后 3 天透明薄膜敷料方案的结果。

Outcomes of a 3-day transparent film dressing protocol after hypospadias repair.

机构信息

Pediatric Surgery Division, Department of Surgery, Faculty of Medicine, Universitas Padjadjaran/Dr. Hasan Sadikin General Hospital, Bandung, Indonesia.

Department of Forensic & Legal Medicine, Faculty of Medicine, Universitas Padjadjaran/Dr. Hasan Sadikin General Hospital, Bandung, Indonesia.

出版信息

Sci Rep. 2024 Oct 15;14(1):24192. doi: 10.1038/s41598-024-68059-6.

Abstract

This study aimed to evaluate a 3-day transparent film dressing protocol after hypospadias repair. A retrospective observational study was conducted in boys with hypospadias who were operated in our institution between 2022 and 2023. Postoperatively, the penis was wrapped with a transparent film dressing, which was removed after 3 days. Postoperative complications were observed until postoperative day 14. The associations of age, meatal location, and type of procedure were analyzed using Chi square, Fisher exact, Mann Whitney, and Kruskall Wallis test (p < 0.05 = significant). Sixty-five patients were studied. Median age was five years, the majority had proximal meatus (58.5%), and underwent urethroplasty (76.9%). After dressing removal, positive bacterial culture was found in 43.1%, mild penile edema in 33.8%, bleeding in 10.8%, and SSI in 49.2% of cases, with pus formation (10.8%), dehiscence (9.2%), and urethrocutaneous fistula (10% after urethroplasty procedure). Surgical site infection and positive culture were significantly higher in patients with proximal meatus compared to distal (p = 0.031, p = 0.019; respectively). A 3-day transparent film dressing prevented penile edema and bleeding in most cases. However, the rate of SSI and positive wound culture was high, and was associated with proximal meatal location.

摘要

本研究旨在评估尿道下裂修复术后 3 天透明膜敷料方案。对 2022 年至 2023 年在我院接受手术的尿道下裂男孩进行回顾性观察性研究。术后阴茎用透明膜敷料包扎,3 天后去除。观察术后至术后第 14 天的并发症。使用卡方检验、Fisher 确切检验、Mann-Whitney 检验和 Kruskal-Wallis 检验分析年龄、尿道口位置和手术类型的相关性(p<0.05=显著)。研究了 65 例患者。中位年龄为 5 岁,大多数患者尿道口位于近端(58.5%),行尿道成形术(76.9%)。去除敷料后,43.1%的病例细菌培养阳性,33.8%的病例轻度阴茎水肿,10.8%的病例出血,49.2%的病例发生手术部位感染,其中 10.8%的病例有脓液形成,9.2%的病例有切口裂开,10%的病例在尿道成形术后发生尿道皮肤瘘。与远端尿道口相比,近端尿道口的患者手术部位感染和阳性培养的发生率显著更高(p=0.031,p=0.019)。3 天透明膜敷料可预防大多数情况下的阴茎水肿和出血。然而,手术部位感染和伤口阳性培养的发生率较高,与近端尿道口位置有关。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e3ac/11480378/091380869614/41598_2024_68059_Fig1_HTML.jpg

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