Abstract
PurposeThis study aimed to evaluate the efficacy of oxygen-enriched oil-based gel dressing on wound healing and postoperative outcome in children who underwent distal hypospadias repair.MethodsWe included all patients with distal hypospadias, who underwent Snodgrass urethroplasty and preputioplasty over an 18-months period. The patients were randomized in two groups according to the type of medication: oxygen-enriched oil-based gel (G1) and hyaluronic acid cream (G2). After discharge, parents changed the dressing twice a day for 2–3 weeks postoperatively. The patients were evaluated at 7, 14, 21, 30, 60 and 180 postoperative days and thereafter annually.ResultsOne-hundred and fourteen patients (median age 18 months) were included in the study and randomized in two groups, each of 57 patients. The wound healing was significantly faster in G1 compared with G2 (p = 0.001). G1 reported significantly higher SWAS and modified HOPE scores compared with G2 (p = 0.001) at all steps of follow-up. No adverse skin reactions occurred. Foreskin dehiscence and re-operations rates were significantly lower in G1 compared with G2 (p = 0.001). Postoperative foreskin retractability was better in G1, with a significantly higher incidence of secondary phimosis in G2 (p = 0.001). The median treatment costs were significantly lower in G1 compared with G2 (p = 0.001).ConclusionPostoperative dressing using oxygen-enriched oil-based gel was highly effective, promoting a faster wound healing in patients who underwent distal hypospadias repair. It reported a lower incidence of foreskin dehiscence and better foreskin retractability compared with the control group. It was cost-effective and clinically safe without allergy or intolerance to the product.
Highlights
Hypospadias repair is one of the most common operations performed by pediatric urologists [1]
This study aimed to evaluate the efficacy of oxygenenriched oil-based gel dressing on wound healing and postoperative outcome in children who underwent distal hypospadias repair
Hypospadias surgery is one of the most common operations performed by pediatric urologists but several controversies still exist regarding the surgical techniques and the postoperative management [1, 6]
Summary
Hypospadias repair is one of the most common operations performed by pediatric urologists [1]. About 300 different surgical techniques have been previously described and used for hypospadias repair [2]. Analyzing the international literature, limited evidence is available regarding different aspects of surgical management of hypospadias, including details of operative technique, type of suture, indications for foreskin reconstruction, type and length of urinary diversion, and postoperative dressing [6]. It should be easy to apply and to remove, non-adherent to the incision; it should effectively absorb the leakages of the wound, produce an adequate compression of the penis, without damaging the blood circulation, preventing hematoma and edema formation and helping wound healing, protect against infections [11, 16, 17] It must keep its shape during the child’s movements, without limiting his normal activities [18]
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