Yuan Yang, Zhang Shihao, Hu Dingli, Wang Bing, Li Yunlong
Department of Urology, Kunshan First People's Hospital, Affiliated to Jiangsu University, Kunshan, China.
Department of Urology, Huaibei First People's Hospital, Huaibei, China.
Medicine (Baltimore). 2025 Feb 28;104(9):e41500. doi: 10.1097/MD.0000000000041500.
This randomized controlled trial aimed to investigate the potential benefits of local application of triamcinolone acetonide combined with topical recombinant bovine basic fibroblast growth factor in promoting wound healing and reducing scar formation after circumcision using a stapler device.
A total of 192 patients with phimosis or redundant prepuce were randomly assigned to either the observation group (n = 96) or the control group (n = 96). Both groups underwent circumcision using a stapler device. Postoperatively, the observation group received wet dressings of 2 mg/mL triamcinolone acetonide solution combined with topical recombinant bovine basic fibroblast growth factor until complete wound healing. The control group received saline wet dressings and standard postoperative wound care. Outcome measures included: postoperative edema, time to resolution of swelling at the incision edges, wound exudate, healing time, staple removal time and rate, scar formation, and patient satisfaction with penile cosmesis.
The observation group demonstrated significantly faster healing times and lower incidence of edema from the seventh postoperative day compared to the control group (P < .05). Furthermore, the observation group exhibited superior outcomes in terms of complete staple removal time, staple detachment rate, scar hypertrophy, and cosmetic scores using the modified Stony Brook Scar Evaluation Scale (P < .05). Patient satisfaction with penile cosmesis was also significantly higher in the observation group (P < .05).
This study underscores the principle of "prevention over treatment" in scar management following stapler circumcision. The findings suggest that the combined use of triamcinolone acetonide and recombinant bovine basic fibroblast growth factor may be beneficial in reducing postoperative edema, improving scar formation, and enhancing patient satisfaction. However, further research is warranted to validate these findings, establish optimal treatment protocols, and ultimately assess the long-term efficacy and safety of this combined therapy.
本随机对照试验旨在研究曲安奈德局部应用联合外用重组牛碱性成纤维细胞生长因子在使用吻合器进行包皮环切术后促进伤口愈合和减少瘢痕形成方面的潜在益处。
总共192例包茎或包皮过长患者被随机分为观察组（n = 96）和对照组（n = 96）。两组均使用吻合器进行包皮环切术。术后，观察组接受2mg/mL曲安奈德溶液湿敷联合外用重组牛碱性成纤维细胞生长因子，直至伤口完全愈合。对照组接受生理盐水湿敷及标准的术后伤口护理。观察指标包括：术后水肿、切口边缘肿胀消退时间、伤口渗出物、愈合时间、拆线时间及拆线率、瘢痕形成情况以及患者对阴茎外观的满意度。
与对照组相比，观察组从术后第7天起愈合时间明显更快，水肿发生率更低（P < 0.05）。此外，在完全拆线时间、吻合钉脱落率、瘢痕增生以及使用改良的石溪瘢痕评估量表的美容评分方面，观察组表现更优（P < 0.05）。观察组患者对阴茎外观的满意度也显著更高（P < 0.05）。
本研究强调了吻合器包皮环切术后瘢痕管理中“预防胜于治疗”的原则。研究结果表明，曲安奈德与重组牛碱性成纤维细胞生长因子联合使用可能有助于减轻术后水肿、改善瘢痕形成并提高患者满意度。然而，需要进一步研究来验证这些发现，制定最佳治疗方案，并最终评估这种联合疗法的长期疗效和安全性。
