Cite as: Can Urol Assoc J 2017;11(1-2):E58-9. ttp://dx.doi.org/10.5489/cuaj.3930 Published online January 12, 2107
AbstractOne of the most controversial aspects of hypospadias surgery is the election of an appropriate wound dressing. In fact, there may be as many different types of dressing as there are types of surgical repair. Here, we describe a new, simple method for hypospadias dressing in children that minimizes painful removal.
MethodOne of the most controversial aspects of modern hypospadias surgery is the election of an appropriate wound dressing.1 Multiple dressings after hypospadias surgery have been previously reported.2 Dressing prevents postoperative edema and hematoma formation, maintaining the phallus in an upright position. Most dressings are bulky, hard to apply or remove, and may fall off in an active child.3 Commonly used dressings are adherent to the surgical wound, making removal more likely to be painful, especially in young children. 4 All the above-mentioned materials have their own set of advantages and disadvantages. Under these conditions, the use of a self-adherent, soft, silicone-foam dressing that minimizes painful removal is really appropriate for hypospadias surgery. The Mepilex ® Border foam sheet is cut according to the penile length and circumference. The lower border of dressing is split in three flaps for self-adherence to pubic and scrotal area (Fig. 1). The foam dressing need to be rolled into a cylindrical shape, wrapping round the penis and closed on the dorsal aspect with adhesive lateral border (Fig. 2). The top of the dressing must be left open to allow the urinary catheter to come through and to see the colour of the glans during postoperative period. No secondary dressings are necessary. The application of this type of dressing is very simple, with no need for previous skills and without increasing the operation time.The dressing is removed after 5-10 days, depending on the urethroplasty procedure performed. The dressing, being non-adherent in the wound area, is easily peeled off with no need of analgesics and minimal discomfort (Fig. 3).
ConclusionSelf-adherent, soft, silicone-foam dressing (Mepilex ® Border) is really accurate for hypospadias surgery in children. It can be easily removed, avoiding harm to the child.
E59Hypospadias dressing in childrenCompeting interests: The authors report no competing personal or financial interests.This paper has been peer-reviewed.
Las duplicaciones intestinales duodenales son entidades raras, principalmente se presentan en la primera o segunda porción, siendo prácticamente excepcional su localización a nivel piloroduodenal, con menos de diez casos descritos en la literatura.Presentamos el caso de una neonata que a las 48 horas de vida manifestó un cuadro de obstrucción intestinal alta que requirió realizar una laparotomía exploradora, observándose un quiste piloroduodenal, que fue resecado en la intervención.Se trata de una entidad congénita extremadamente rara, los signos y síntomas son un desafío y el objetivo quirúrgico debe ser la exéresis completa. Si la resección total origina compromiso de los órganos adyacentes, la exéresis parcial con mucosectomía es una alternativa válida para evitar las complicaciones de una cirugía más agresiva.
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