Xu Haihua,Xu Guodong,Zhang Fuyi,et al.Curative efficacy of co-application of flap dot suturing,collagen sponge and basic fibroblast growth factor for preventing postoperative necrosis of hypospadias[J].Journal of Clinical Pediatric Surgery,,18():1053-1056.[doi:10.3969/j.issn.1671-6353.2019.12.013]
Curative efficacy of co-application of flap dot suturing,collagen sponge and basic fibroblast growth factor for preventing postoperative necrosis of hypospadias
- Keywords:
- Hypospadias; Surgical Flaps; Suture Techniques; Collagen Sponge
- CLC:
- R726.9;R695
- Abstract:
- Objective To explore the characteristics and curative efficacy of co-application of dot suturing fixation on transposition flap,collagen sponge and basic fibroblast growth factor (bFGF) for preventing postoperative necrosis of hypospadias. Methods From March 2017 to March 2018,44 eligible hypospadias cases were selected.The same operative approach of straightening plus urethroplasty plus transplantation pedicled flap from dorsal part to ventral part for covering urethra plus posthioplasty was employed for research group.And,between May 2015 and December 2016,another 44 cases with similar characteristics were selected randomly as control group.In research group,suturing fixation was applied on transposition flap and wound covered with collagen sponge and bFGF after 1 week.Dressing was replaced daily for observing healing condition.In control group,dot suturing was skipped.After removing dressing,erythromycin eye ointment was smeared. Results In research group,vascular supply of transposition flap recovered better.There were only 3 cases of urethral fistula and the occurrence rate was 6.8%; In control group,urethral fistula (n=10) had an occurrence rate of 22.7% and the difference was statistically significant (P<0.05).And hospital stay of research and control groups were (13.45±1.98) and (15.23±1.68) days respectively and the difference was statistically significant (P<0.01).No other complications occurred. Conclusion Suturing fixation on transposition flap may eliminate dead space and improve flap vascular supply.Co-application of collagen sponge and bFGF can promote wound skin healing and shorten hospitalization stay.During the whole therapeutic process,there is no onset of anaphylactic or adverse reactions.
References:
1 Snodgrass WT,Bush NC.Hypospadias,Campbell-Walsh Urology[M].Philadelphia:Elsevier,2016:3399.
2 贾江华,齐进春,杜蕾,等.69例尿道下裂术后尿道狭窄的治疗经验分析[J].临床小儿外科杂志,2019,18(6):514-517.DOI:10.3969/j.issn.1671-6353.2019.06.015. Jia JH,Qi JC,Du L,et al.Diagnosis and treatment of urethral stricture after hypospadias operations:a report of 69 cases[J].J Clin Ped Sur,2019,18(6):514-517.DOI:10.3969/j.issn.1671-6353.2019.06.015.
3 李明勇,胡威,李清,等.尿道下裂TIP手术后尿瘘与手术年龄的相关性分析[J].临床小儿外科杂志,2017,16(5):451-454.DOI:10.3969/j.issn.1671-6353.2017.05.008. Li MY,Hu W,Li Q,et al.Relative study on age and the incidence of urinary fistula after hypospadias TIP[J].J Clin Ped Sur,2017,16(5):451-454.DOI:10.3969/j.issn.1671-6353.2017.05.008.
2 Zhao W,Han Q,Lin H,et al.Improved neovascularization and wound repair by targeting human basic fibroblast growth factor (bFGF) to fibrin[J].J Mol Med (Berl),2008,86(10):1127-1138.DOI:10.1007/s00109-008-0372-9.
3 HataY,Kawanabe H,HisanagaY,et al.Effacts of basic fibroblast growth factor administration on vascular changes in wound healing of ratpalates[J].Cleft Palate Craniofac J,2008,45(1):63-72.DOI:10.1597/06-166.1.
4 伊海英,孙晓艳,付小兵,等.碱性成纤维细胞生长因子的研究进展[J].解放军医学杂志,2008,33(6):776-778.DOI:10.3321/j.issn:0577-7402.2008.06.045. Yi HY,Sun XY,Fu XB,et al.Resaerch progress of the basic fibroblast growthfactor[J].Medical Journal of Chinese People’s Liberation Army,2008,33(6):776-778.DOI:10.3321/j.issn:0577-7402.2008.06.045.
5 覃凤均,陈旭,李迟.胶原蛋白海绵治疗II度烧伤创面的临床疗效研究[J].中国全科医学,2010,13(18):1994-1996.DOI:10.3969/j.issn.1007-9572.2010.18.015. Qin FJ,Chen X,Li C.Clinical curative effects evaluation of collagen sponge for II degree burn surface[J].Chinese General Practice,2010,13(18):1994-1996.DOI:10.3969/j.issn.1007-9572.2010.18.015.
6 Bektas CK,Kimiz I,Sendemir A,et al.A bilayer scaffold prepared from collagen and carboxymethyl cellulose for skin tissue engineering applications[J].J Biomater Sci Polym Ed,2018,29(14):1764-1784.DOI:10.1080/09205063.2018.1498718.
7 卫秀洋,王万明,陈勇忠,等.胶原蛋白海绵复合bFGF促进兔胫骨外露创面愈合的实验研究[J].中国医药指南,2012,10(23):399-401.DOI:10.3969/j.issn.1671-8194.2012.23.303. Wei XY,Wang WM,Chen YZ,et al.Basic fibroblast growth factor and collagen sponge improve rabbits skin wound healing with exposed tibia[J].Guide of China Medicine,2012,10(23):399-401.DOI:10.3969/j.issn.1671-8194.2012.23.303.
8 卞徽宁,陈华德,郑少逸,等.外源性碱性成纤维细胞生长因子对创面愈合病理变化的影响[J].感染、炎症、修复,2006,7(4):206-209.DOI:10.3969/j.issn.1672-8521.2006.04.004. Bian HN,Chen HD,Zheng SY,et al.An experimental study in wound healing with the application of exogenous basic fibroblast growth factor[J].Infection Inflammation Repair,2006,7(4):206-209.DOI:10.3969/j.issn.1672-8521.2006.04.004.
9 何军,雍江,尹智峰,等.尿道下裂患儿性激素水平的检测及意义[J].中国医师杂志,2016,18(11):1634-1636,1641.DOI:10.3760/cma.j.issn.1008-1372.2016.11.010. He J,Yong J,Yin ZF,et al.Detection of sex hormone levels in children with hypospadias[J].Journal of Chinese Physician,2016,18(11):1634-1636,1641.DOI:10.3760/cma.j.issn.1008-1372.2016.11.010.
10 张小明,何恢绪,胡卫列,等.生殖器皮瓣加盖在尿道下裂术后再次手术中的应用[J].中国医师杂志,2010,12(7):943-944.DOI:10.3760/cma.j.issn.1008-1372.2010.07.032. Zhang XM,He XH,Hu WL,et al.Application of genital flap covering in re-operations for hypospadias[J].Journal of Chinese Physician,2010,12(7):943-944.DOI:10.3760/cma.j.issn.1008-1372.2010.07.032.
Memo
收稿日期:2018-01-28。
通讯作者:徐国栋,Email:dongyan615@163.com