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自体富血小板纤维蛋白膜作为尿道下裂手术后尿道皮肤瘘修复覆盖层的手术评估:一项随机对照试验

Surgical Evaluation of Autologous Platelet-rich Fibrin Membrane as a Coverage Layer in Repair of Urethrocutaneous Fistula after Hypospadias Surgeries: A Randomized Controlled Trial.

作者信息

Wishahy Ahmed Mohamed Kadry, Abdullateef Khaled Salah Ahmed, Kaddah Sherif Nabhan, Mohamed Alaa Ali, Mohamed Mahmoud Tarek

机构信息

Department of Pediatric Surgery, Cairo University, Giza, Egypt.

出版信息

J Indian Assoc Pediatr Surg. 2024 Sep-Oct;29(5):505-510. doi: 10.4103/jiaps.jiaps_149_22. Epub 2024 Aug 23.

Abstract

PURPOSE

It has recently been reported that the use of platelet-rich fibrin (PRF) as an extralayer over the urethroplasty has been related to a considerable reduction in fistula rates. Due to the lack of evidence supporting the usage of PRF in urethrocutaneous fistula (UCF) repair, we conducted this study to evaluate the efficacy of PRF in patients with UCF.

MATERIALS AND METHODS

We conducted a randomized controlled study on patients with distal fistula after hypospadias repair. Patients were randomized into two groups, one with local dartos coverage and the other with PRF coverage layer.

RESULTS

In the present study, we included 37 patients; 20 patients underwent local dartos coverage, and 17 patients underwent PRF. The mean age was 22.45 ± 4545 ± 4515 ± ±15.35 (range 11-56) months for the study group and 20.6 ± 66 ± 614 ± ±14.5 (range 6-45) months for the control group. The incidence of recurrent UCF was 11.8% in the treatment group (two patients), whereas the incidence was 30% (six patients) in the control group ( = 0.246).

CONCLUSION

UCF surgery may benefit from the use of PRF as a supportive tissue that promotes wound healing, angiogenesis, and tissue restoration. We believe that the use of PRF as a new approach for UCF repair should be investigated further through clinical studies.

摘要

目的

最近有报道称,在尿道成形术上使用富血小板纤维蛋白(PRF)作为额外层与瘘管发生率的显著降低有关。由于缺乏支持PRF用于尿道皮肤瘘(UCF)修复的证据,我们开展了这项研究以评估PRF对UCF患者的疗效。

材料与方法

我们对尿道下裂修复术后远端瘘的患者进行了一项随机对照研究。患者被随机分为两组,一组采用局部肉膜覆盖,另一组采用PRF覆盖层。

结果

在本研究中,我们纳入了37例患者;20例患者采用局部肉膜覆盖,17例患者采用PRF覆盖。研究组的平均年龄为22.45±4545±4515±±15.35(范围11 - 56)个月,对照组为20.6±66±614±±14.5(范围6 - 45)个月。治疗组复发性UCF的发生率为11.8%(2例患者),而对照组的发生率为30%(6例患者)(P = 0.246)。

结论

UCF手术可能受益于使用PRF作为促进伤口愈合、血管生成和组织修复的支持性组织。我们认为,应通过临床研究进一步探讨将PRF作为UCF修复新方法的应用。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1170/11521221/6748720273fc/JIAPS-29-505-g001.jpg

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