Evaluation of clinical effect of vacuum sealing drainage and moist healing technology in the treatment of hypospadias of children
10.3760/cma.j.issn.1009-4598.2020.02.013
- VernacularTitle:负压封闭引流及湿性愈合技术在小儿尿道下裂治疗中的效果评价
- Author:
Lihua GUO
1
;
Qian ZHANG
;
Lei WANG
;
Ji LI
;
Yingzhong FAN
Author Information
1. 郑州大学第一附属医院小儿泌尿外科 450052
- Keywords:
Hypospadias;
Vacuum sealing drainage;
Moist healing;
Children
- From:
Chinese Journal of Plastic Surgery
2020;36(2):180-184
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To evaluate the efficacy and safety of vacuum sealing drainage(VSD)and moist healing technology in the treatment of hypospadias of children.Methods:From January 2015 to January 2017, 80 cases of children with proximal hypospadias and moderate or severe penile curvature from 1.5 years to 12 years old who received hypospadias operation were assigned into the study group(SG)( n=40)and control group(CG)( n=40), based on simple randomization. 80 cases of children were done operation included correcting the penile curvature and urethroplasty(Duckett urethroplasty)by one surgeon, all of them were received the procedure covered the urethra by scrotal septum tissue. The cases of SG were installed VSD after covered soft polysilicone wound dressing (merlot), who underwent treatment of slowly flushing by saline solution(liquid drop, 7 drops/min)and attracting by negative pressure(negative pressure range, from -30 kpa to -20 kpa)for 7 days. The cases of CG were bound up the penis with merlot, gauze and self-adhesive elastic bandage for 7 days. All cases of two group were sterilize by iodophor after opening dressing, smeared erythromycin ointment and applied hydropathic compress by wet gauze to help blood scab accelerate to drop, when blood scab appeared. All cases were conventionally reserved with F8 catheter for 1 month. The standard of successful operation was that there was no complication, included urethral fistula, urethral stenosis, urethral dehiscence, urethrocele and dysuresia. Results:The children of SG were found to be well tolerated to VSD, there was no adverse reaction to VSD. 7 days after operation, incidence of blood scab(20%, 8/40)and rate of under-scab infection of SG(12.5%, 5/40) were lower than CG[42.5%(17/40), 32.5%(13/40)], the differences were statistically significant( χ2=4.713, P=0.030; χ2=4.588, P=0.032). 1 month postoperation, urethral fistula 5 cases, urethral stenosis 1 case were found in SG, otherwise CG complications included urethral fistula 9 cases, urethral dehiscence 1 case and urethral stenosis 1 case. The success rate of surgery of SG was higher than CG[85(34/40) vs 72.5%(29/40)%]. Conclusions:Applying VSD continuously slowly flushing and extracting by negative pressure to hypospadias treatment is effective and safe, which could effectively reduce the blood scab formation and the rate of under-scab infection, which can increase the success rate of hypospadias surgery.
