Novosti
Khirurgii

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Year 2022 Vol. 30 No 1

PEDIATRIC SURGERY

R.A. NAKONECHNYY, A.Y. NAKONECHNYI

OPTIMIZATION OF SURGICAL WOUND CARE AFTER URETHROPLASTY IN CHILDREN WITH HYPOSPADIA

Danylo Halytsky Lviv National Medical University, Lviv,
Ukraine

Objectives. To develop optimal postoperative wound care tactics for boys with hypospadias.
Methods. The patients (128) with hypospadias aged from 11 months to 7 years were examined. The main group A consisted of 83 (64.8%) patients in whom we used a special bandage. It includes layer by layer of soft polyamide net two-sided onlay coated with soft silicone and adhesive properties, abundantly treated with an antimicrobial ointment containing an osmotic agent, sterile absorbent wipes with non-woven material, a circularly applied elastic bandage and an adhesive plaster with porous non-woven material. The dressing usually held up to 5 days. Group B included 45 (35.2%) patients with hypospadias, in whom we used a conventional sterile circular gauze bandage with antimicrobial ointment. The gauze bandage changed daily. For all clinical symptoms the groups were comparable in age.
Postoperative wound healing had been monitored for 10 days after urethroplasty. The emphasis was made on such criteria as bleeding with hematoma formation, copious exudate excretion, penis skin hyperemia, «soft» and «dense» edema, drying crust (scab), skin sutures dehiscence, hypergranulation and necrosis.
Results. In group A, problems with the skin flap and postoperative wound were detected only in 17 (20.5%) boys on the second or third day after removal of the special bandage. In the postoperative period, 41 (91.1%) patients in group B had «painful» skin changes in the area of the postoperative wound, which appeared almost the next day after surgery.
Conclusion. The use of special bandage delays in time the contact of microbiota penis tissues compromised by surgery and the external environment, which, no doubt, improves the healing of skin grafts in the early postoperative period, and therefore reduces the number of urethroplasty complications.

Keywords: hypospadia, urethroplasty, postoperative wound, wound healing, bandage
p. 46-53 of the original issue
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Address for correspondence:
79059, Ukraine,
Lviv, Pylyp Orlyk Street, 4,
Danylo Halytsky Lviv National Medical University,
the Department of Pediatric Surgery,
tel.mob.: +38-067-254-33-71,
tel. work: +38-032-293-97-39;
e-mail: nrostyslav@gmail.com
Nakonechnyi Rostyslav A.
Information about the authors:
Nakonechnyy Rostyslav A., PhD, Assistant of the Department of Pediatric Surgery, Danylo Halytsky Lviv National Medical University, Lviv, Ukraine.
https://orcid.org/0000-0003-0645-3361
Nakonechnyi Andrii Y., MD, Professor of the Department of Pediatric Surgery, Vice-Rector (Science), Danylo Halytsky Lviv National Medical University, Lviv, Ukraine.
https://orcid.org/0000-0003-1402-6642
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