Does the Choice of Suture Material Affect the Incidence of Urethrocutaneous Fistulae After Hypospadias Repair? – A Comparison of Polyglactin 910 with Polydioxanone

Author(s):  
Adnan Khalid ◽  
Syed Hashim Zaidi ◽  
Marvi Baloch ◽  
Fahad Saleem

Background: We aimed to assess the incidence of developing postoperative urethrocutaneous fistulae (UCF) while using either polyglactin 910 or polydioxanone for the repair of subcoronal hypospadias in paediatric patients. Methods: A multicenter, two-group posttest-only randomized experimental design was adopted for the study. The study was conducted at PNS Shifa Hospital Karachi, Combined Military Hospital Malir, Military Hospital Rawalpindi and Combined Military Hospital Multan from 2009 to 2016. Boys between the ages of 1 – 10 years with confirmed diagnosis of subcoronal hypospadias suitable for single stage repair with the Snodgrass technique and also completing a minimum follow up of 6 months were targeted for the study. The subjects were later randomized into PG group (those undergoing urethral repair with polyglactin 901) and PD group (those in whom polydioxanone was used). Both descriptive and inferential statistics were used for data analysis. SPSS v. 21.0 was used for data analysis with p > 0.05 taken as significant value. Results: Two hundred patients with confirmed diagnosis of subcoronal hypospadias were recruited for the study in the proposed study period. Twenty-nine patients (29%) in the PG and 26 (26%) in the PD group developed UCF. There were seven (7%) cases of wound infection in the PG group compared to four cases (4%) in the PD Group; all eleven of the said were among those who developed UCF. Meatal stenosis was observed in six patients (6%) in the PG group and in nine patients (9%) of the PD group. No significant difference in the incidence of postoperative urethral fistula formation with the use of polyglactin 910 versus polydioxanone was however reported by the study findings. Conclusion: As there was no significant difference in the incidence UCF between Polyglactin 910 and Polydioxanone, the choice of suture material should be based on economical variations and availability of the two products.

Author(s):  
Acharya K. ◽  
Khatua S. ◽  
Pal S.

Background: We aimed to assess the incidence of developing postoperative urethrocutaneous fistulae (UCF) while using either polyglactin 910 or polydioxanone for the repair of subcoronal hypospadias in paediatric patients. Methods: A multicenter, two-group posttest-only randomized experimental design was adopted for the study. The study was conducted at PNS Shifa Hospital Karachi, Combined Military Hospital Malir, Military Hospital Rawalpindi and Combined Military Hospital Multan from 2009 to 2016. Boys between the ages of 1 – 10 years with confirmed diagnosis of subcoronal hypospadias suitable for single stage repair with the Snodgrass technique and also completing a minimum follow up of 6 months were targeted for the study. The subjects were later randomized into PG group (those undergoing urethral repair with polyglactin 901) and PD group (those in whom polydioxanone was used). Both descriptive and inferential statistics were used for data analysis. SPSS v. 21.0 was used for data analysis with p > 0.05 taken as significant value. Results: Two hundred patients with confirmed diagnosis of subcoronal hypospadias were recruited for the study in the proposed study period. Twenty-nine patients (29%) in the PG and 26 (26%) in the PD group developed UCF. There were seven (7%) cases of wound infection in the PG group compared to four cases (4%) in the PD Group; all eleven of the said were among those who developed UCF. Meatal stenosis was observed in six patients (6%) in the PG group and in nine patients (9%) of the PD group. No significant difference in the incidence of postoperative urethral fistula formation with the use of polyglactin 910 versus polydioxanone was however reported by the study findings. Conclusion: As there was no significant difference in the incidence UCF between Polyglactin 910 and Polydioxanone, the choice of suture material should be based on economical variations and availability of the two products.


2021 ◽  
Vol 2 (2) ◽  
pp. 236-242
Author(s):  
Vovi Tridian Ulfah ◽  
Yulianto Santoso ◽  
Yulianto Santoso ◽  
Rifma Rifma ◽  
Ermita Ermita

Academic Supervision is a series of activities to assist in developing teacher professionalism in the implementation of learning with students carried out by leaders in schools, namely the principal. Academic supervision activities are carried out to help teachers improve learning activity planning, learning implementation, learning evaluation, and learning device preparation. This study aims to determine the implementation of the principal's academic supervision and see whether there is a significant difference in the implementation of the principal's academic supervision at SMKN 1 Padang Gelugur with SMKN 1 Rao selatan. This type of research is comparative descriptive and data collection is done by distributing questionnaires that have been tested for their validity and reliability. Before the data were analyzed, the data had been tested for normality and homogeneity and then performed the t-test to determine the difference value. Acquisition of data analysis is 1) academic supervision planning obtained 82.27% with the effective category. 2) the implementation of academic supervision obtained 79.34 in the quite effective category. 3) feedback and follow-up from the results of academic supervision obtained 75.2% including in the quite effective category. After testing the hypothesis using the SPSS application, namely the t-test, the result was that there was a difference in the implementation of the principal's academic supervision at SMKN 1 Padang Gelugur and SMKN 1 Rao Selatan because t count (2.154) <from t table (2.66). Based on the research results, the implementation of the principal's academic supervision at SMKN 1 Padang Gelugur was 1.08% more effective than SMKN 1 Rao Selatan.


2014 ◽  
Vol 8 (7-8) ◽  
pp. 236 ◽  
Author(s):  
Emilie Baillargeon ◽  
Kai Duan ◽  
Alex Brzezinski ◽  
Roman Jednak ◽  
Mohamed El-Sherbiny

Introduction: We sought to determine whether the use of preoperative antibiotics is effective in reducing postoperative wound infections and urinary tract infections (UTI) in hypospadias repair.Methods: We retrospectively reviewed all hypospadias repairs performed at the Montreal Children’s Hospital between March 2009 and September 2012. All types of primary hypospadias repairs and redo cases were included. Patients with no adequate follow-up or with missing records of antibiotics were excluded. Preoperative antibiotics were given in the form of cefazolin (50 mg/kg intravenously) when appropriate. Postoperative oral antibiotics were administered as decided by the pediatric urologist. Primary outcomes included postoperative wound infection and UTI. Secondary outcomes included the need for reoperation of hypospadias due to urethrocutaneous fistula, meatal stenosis, urethral stricture and wound dehiscence.Results: In total, 157 cases of hypospadias repair were reviewed; of these 7 were excluded due to lack of follow-up. Of the remaining 150 patients, 62 received preoperative antibiotics and 88 did not. The groups were well-matched for age, hypospadias characteristics, type of repair and repair of curvature. The group that received preoperative antibiotics had a significantly higher number of stented cases (82% vs. 52% of the non-preoperative antibiotic group). Two cases of wound infection were reported (1 in the preoperative antibiotic group and 1 in the non-preoperative antibiotic group). There was no symptomatic UTI or culture-demonstrated UTI in either group. Moreover, there was no statistically significant difference between the 2 groups in terms of primary outcomes. The complication rate was 11% (17/150 repairs) and all patients needed reoperation. This study’s important limitations include the rarity of studied end points combined with the small sample and the retrospective nature of our study.Conclusion: Our findings do not support the routine use of preoperative antibiotics in hypospadias repair.


QJM ◽  
2020 ◽  
Vol 113 (Supplement_1) ◽  
Author(s):  
H M Abdallah ◽  
A M Tawfeek ◽  
A M W Mohareb

Abstract Background urethrocutaneous fistula (UCF) is still the commonest complication after hypospadias repair. Although recent advances in the surgical procedures of hypospadias repair have reduced the rate of urethrocutaneous fistula formation, it remains a real complication of hypospadias and frustrating problem for surgeons. Aim of the Work evaluation of success and failure rates of using cyanoacrylate based productes as an interpositioning substance in surgical repair of fistula after hypospadias in comparison to the classic surgical repair technique. Patients and Methods this is a prospective, randomized-controled study, conducted on 40 patients from the date of the approval of the study. It is comparing two different modalities for repair of urethrocutaneous fistula that has developed after hypospadias repair. Our study was assigned on a randomized basis method according to a 1:1 ratio and patients underwent either multilayered closure using dartos facial flap or using cyanoacrylate glue as an interpositioning layer before suturing of the dartos flap for the closure of the urethrocutaneous fistula. All cases were divided into 2 equal groups, 20 cases each. The cases were distributed randomly into the two groups. Results the success rate was higher for patients using cyanoacrylate glue as a protective interpositioning layer as 16 patients (80%) were successfully repaired and 4 patients (20%) developed a recurrent fistula. However, there was no statistically significant difference between 2 groups p-value was 0.465. Conclusion there was no statistically significant difference in adding cyanoacrylate glue to multilayered closure of urethrocutaneous fistula after hypospadias repair. However, cyanoacrylates showed that they are a favourable additional protective substance and they resulted in a high success rate without adding any surgical complications.


Esculapio ◽  
2021 ◽  
Vol 17 (2) ◽  
pp. 187-190
Author(s):  
Muhammad Abdullah ◽  
Muhammad Saleem ◽  
Ghulam Mujtaba Zafar ◽  
Farrukh Mehmood Sattar ◽  
Imran Hashim ◽  
...  

Objectives: To compare 21 days versus 10 days bladder catheterization after hypospadias repair. Methods: After approval from ethical committee, Randomised controlled trial performed, in which 196 male patients were enrolled in the study that was conducted at department of pediatric surgery, Children hospital, Lahore. All patients underwent Snodgrass procedure. Group-1 patients were considered for 10 days bladder catheterization for hypospadias repair and group-2 patients were catheterized for 21 days. Complications were documented on follow-up visits in group 1 at 1 week (17 days), 3 weeks (34 days), and 6 weeks (51 days) after catheter removal. In group 2 at 1 week (day 28th), 3 weeks (day 42nd), 6 weeks (day 63rd) after catheter removal. Results: The mean age in group-1 and group-2 was 7.25 ± 3.22 years and 6.29±3.02 years. There were significantly less cases of urethrocutaneous fistula in group 2 when compared to group 1. Urethro-cutaneous fistulas (UCF) developed in 13(13.26%) ,11(11.22%) and 10 (10.2%) cases at 1, 3, and 6 weeks post catheter removal follow up in group 1. While in group 2 UCF developed in 4 (4.08%), 3(3.1%) and 2(2.04%) at 1, 3, and 6 weeks follow up. There were 5(5.2%) and 4(4.1%) cases of post-operative wound infection in groups 1 and 2 respectively (p-value = 0.500). Wound dehiscence was seen in 1 (1.02%) case in group 1 and was not seen in group 2(p value =0.500). glans dehiscence was not seen in group 1 while 1 (1.02%) case seen in group 2 (p value 0.500). Conclusion: We conclude that 21 days catheterization after hypospadias repair gives better outcome and fewer complications when compared to 10 days catheterization. Keywords: Bladder catheterization; Hypospadias repair; Fistula formation. How to cite: Abdullah M., Saleem M., Zafar M.G., Sattar M.F., Hasnain I, Wasti R.A. Comparison of 21 Days Versus 10 Days Bladder Catheterization for Hypospadias Repair. Esculapio 2021;17(02):187-190.


VASA ◽  
2015 ◽  
Vol 44 (6) ◽  
pp. 451-457 ◽  
Author(s):  
Vincenzo Gasbarro ◽  
Luca Traina ◽  
Francesco Mascoli ◽  
Vincenzo Coscia ◽  
Gianluca Buffone ◽  
...  

Abstract. Background: Absorbable sutures are not generally accepted by most vascular surgeons for the fear of breakage of the suture line and the risk of aneurysmal formation, except in cases of paediatric surgery or in case of infections. Aim of this study is to provide evidence of safety and efficacy of the use of absorbable suture materials in carotid surgery. Patients and methods: In an 11 year period, 1126 patients (659 male [58.5 %], 467 female [41.5 %], median age 72) underwent carotid endarterectomy for carotid stenosis by either conventional with primary closure (cCEA) or eversion (eCEA) techniques. Patients were randomised into two groups according to the type of suture material used. In Group A, absorbable suture material (polyglycolic acid) was used and in Group B non-absorbable suture material (polypropylene) was used. Primary end-point was to compare severe restenosis and aneurysmal formation rates between the two groups of patients. For statistical analysis only cases with a minimum period of follow-up of 12 months were considered. Results: A total of 868 surgical procedures were considered for data analysis. Median follow-up was 6 years (range 1-10 years). The rate of postoperative complications was better for group A for both cCEA and eCEA procedures: 3.5 % and 2.0 % for group A, respectively, and 11.8 % and 12.9 % for group B, respectively. Conclusions: In carotid surgery, the use of absorbable suture material seems to be safe and effective and with a general lower complications rate compared to the use of non-absorbable materials.


2000 ◽  
Vol 39 (01) ◽  
pp. 10-15 ◽  
Author(s):  
S. P. Müller ◽  
Ch. Reiners ◽  
A. Bockisch ◽  
Katja Brandt-Mainz

Summary Aim: Tumor scintigraphy with 201-TICI is an established diagnostic method in the follow-up of differentiated thyroid cancer. We investigated the relationship between thyroglobulin (Tg) level and tumor detectability. Subject and methods: We analyzed the scans of 122 patients (66 patients with proven tumor). The patient population was divided into groups with Tg above (N = 33) and below (N = 33) 5 ng/ml under TSH suppression or above (N = 33) and below (N = 33) 50 ng/ml under TSH stimulation. Tumor detectability was compared by ROC-analysis (True-Positive-Fraction test, specificity 90%). Results: There was no significant difference (sensitivity 75% versus 64%; p = 0.55) for patients above and below 5 ng/ml under TSH suppression and a just significant difference (sensitivity 80% versus 58%; p = 0.04) for patients above and below 50 ng/ml under TSH stimulation. In 18 patients from our sample with tumor, Tg under TSH suppression was negative, but 201-TICI-scan was able to detect tumor in 12 patients. Conclusion: Our results demonstrate only a moderate dependence of tumor detectability on Tg level, probably without significant clinical relevance. Even in patients with slight Tg elevation 201-TICI scintigraphy is justified.


2018 ◽  
Vol 5 (1) ◽  
Author(s):  
Danuri Danuri ◽  
Dwendha Lahitani

This study aims to determine the effectiveness of CSM strategies on comprehension reading skills in classes V Padokan 2 Elementary School. The research method used is a quasi-experimental method. In this study the subjects of the study were VA class students as the control class and V C as the experimental class with 28 VA and VC class students. Quantitative data analysis technique used is the calculation of independent sample t-test. Based on data analysis and discussion, researchers can conclude that CSM strategies are more effective than conventional methods of reading comprehension learning. The results of this study indicate that there is a significant difference between the experimental class and the control class as evidenced by the results of the independent sample t-test obtained by the value of Asymp. Sig (2-Tailed) 0.014 <0.05. CSM strategy is an effective learning strategy seen from the average value of the experimental class posstest which is 81.61 higher than the control class average value of 72.96.


2018 ◽  
Vol 1 ◽  
pp. 107
Author(s):  
Adi Heryadi ◽  
Evianawati Evianawati

This study aims to prove whether transformational leadership training is effective for building anti-corruption attitudes of villages in Kebonharjo village, subdistrict Samigaluh Kulonprogo. This research is an experimental research with one group pre and posttest design.Subject design is 17 people from village of 21 candidates registered. Measuring tool used in this research is the scale of anti-corruption perception made by the researcher referring to the 9 anti-corruption values with the value of reliability coefficient of 0.871. The module used as an intervention made by the researcher refers to the transformational leadership dimension (Bass, 1990). The data collected is analyzed by statistical analysis of different test Paired Sample Test. Initial data collection results obtained sign value of 0.770 which means> 0.05 or no significant difference between anti-corruption perception score between before and after training. After a period of less than 1 (one) month then conducted again the measurement of follow-up of the study subjects in the measurement again using the scale of anti-corruption perception. The results of the second data collection were analysed with Paired Samples Test and obtained the value of 0.623 sign meaning p> 0.05 or no significant difference between post test data with follow-up data so that the hypothesis of this study was rejected.


Author(s):  
Sanjeeva Kumar Goud T ◽  
Rahul Kunkulol

The present study was aimed to study the effect of Sublingual Vitamin D3 on Serum Vitamin D level in Vitamin D deficiency patients. This was a cross-sectional and interventional study. All the Vitamin D deficiency patients of age 18-60years and either gender, willing to participate in the study were included. Patients who had greater than 20 ng/ml were excluded from the study. The total number of participants in our study was 200, out of these 111 males and 89 females, the mean age in our study was 51.07 ± 7.39Yrs. All volunteers were given sublingual vitamin D3 (60,000IU) in six doses every fifteen days of follow up for 3 months. The subject’s serum 25(OH)D levels were estimated before and after the treatment of sublingual vitamin D3. There was a statistically significant difference in serum vitamin D3 level before 16.61±6.71 ng/ml and after 35.80±7.80 ng/ml after treatment with Sublingual Vitamin D3. Six doses of 60,000IU of Vitamin D3 sublingual route having improved the role of serum 25(OH)D levels in the treatment of Vitamin D3 deficiency patients.Keywords: Vitamin D3; Sublingual route


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