The Use of Autologous Platelet Rich Fibrin Membrane as a Second Layer in Snodgrass Repair of Distal Hypospadias

Al-Awadi, Ahmed Shaker Fouad; Megahed, Hazem A; Shahin, Mohamed M.; Aziz, Fahmy Alsayed Abdul

doi:10.21608/ijma.2021.44160.1181

Cited by 2 publications

(2 citation statements)

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“…The incidence of UCF was 10% in their case series. Similarly, Al-Awadi et al [ 20 ] have performed TIP repair using PRF in their case series of 30 patients with a 6.7% incidence of UCF. Both these studies have an incidence of UCF close to the pooled incidence of our meta-analysis, i.e.…”

Section: Discussionmentioning

confidence: 99%

“…Over the last 10 years, many case series [ 19 , 20 ] and comparative studies [ 21–23 ] were published using autologous platelet-rich concentrate as a barrier layer or adjuvant to the barrier layer during urethroplasty. This systematic review and meta-analysis aim to systematically compare outcomes of hypospadias surgery in children with or without autologous platelet concentrates.…”

Section: Introductionmentioning

confidence: 99%

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Use of an Autologous Platelet-Rich Concentrate in Hypospadias Repair: A Systematic Review and Meta analysis

Borkar

Tiwari

Mohanty

et al. 2022

Arab Journal of Urology

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Background There is unanimous agreement amongst hypospadias surgeons to use an intermediate layer to cover the neourethra. Dartos fascia and tunica vaginalis (TV) flaps are the most preferred tissues to be used. Tissue glue, sealants and biomaterials are also useful where there is a paucity of local tissue to cover the neourethra. But these blood-derived products have associated infectious and allergic risks. The autologous human platelet concentrate (APC) contains biologically active factors and is safe for wound healing and soft tissue reconstruction. It has been used by few surgeons as an intermediate layer in hypospadias repair. This systematic review and meta-analysis aim to systematically compare the outcomes of hypospadias surgery in children with or without using APCs. Methods This systematic review and meta-analysis was conducted as per the Preferred Reporting Items for Systematic Review and Meta-Analysis (PRISMA) guidelines. Meta-analysis protocol was registered with INPLASY. A systematic, detailed search was carried out by the authors in the electronic databases, including Medline, Embase, CENTRAL, Scopus, Google Scholar and clinical trial registry. Studies were selected and compared based on primary outcome measures like urethra-cutaneous fistula, meatal stenosis, wound infection and operative time. Statistical analysis was performed using a fixed-effect model, pooled risk ratio and I 2 heterogeneity. Results Four randomized studies with a total of 355 patients were included. Pooled analysis for outcome of urethra-cutaneous fistula (UCF) showed no significant difference between the groups with APC and without APC. Pooled analysis for the other outcome like meatal stenosis, wound infection and total complications showed a decrease in incidence of these complications in groups with APC. Conclusion This meta-analysis shows that there is a reduction in the incidence of wound infection, meatal stenosis and total complications in patients where APC was used to cover the neourethra, although no such difference was observed in UCF rates.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Use of an Autologous Platelet-Rich Concentrate in Hypospadias Repair: A Systematic Review and Meta analysis

Borkar

Tiwari

Mohanty

et al. 2022

Arab Journal of Urology

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The use of an autologous platelet-rich fibrin membrane in urethroplasty for cases of distal hypospadias

Abdelazim,

Abdullateef,

Khedr

et al. 2024

Egypt Pediatric Association Gaz

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Background Among pediatric surgical procedures, hypospadias surgery is one of the most difficult. The most prevalent complication following hypospadias repair is urethrocutaneous fistula. Numerous procedures have been developed to prevent and resolve this issue. One such method is platelet-rich fibrin (PRF) membrane preparation, which is a straightforward process requiring only the patient’s serum. It has already been utilized successfully in plastic and reconstructive surgeries, where it significantly enhances the healing capacity and decreases the risk of infections. The purpose of this study is to assess the efficacy of an autologous PRF membrane in promoting healing and reducing fistula occurrence in cases of de novo distal hypospadias. Methods Forty patients with primary distal hypospadias underwent TIP repair, as a part of a prospective controlled randomized study from April 2017 to February 2018. The cases were randomly allocated into two categories. TIP repair done in all cases by the same surgeon. Twenty cases comprised group A, which utilized a preputial or local dartos flap as an additional protective layer over the urethroplasty. In contrast, group B comprised 20 cases in which the urethroplasty was covered with a PRF membrane. The initial follow-up duration was 6 months. Each group’s fistula incidence and other associated complications were documented. Results Two groups were compared during the initial 6-month follow-up period. There were seven cases of urethrocutaneous fistula in group A, representing a 35% incidence rate. In group B, there were two cases that had fistula with an incidence of 10% in the early postoperative period. Two patients (10%) in group A developed meatal stenosis and only one patient in group B (5%) developed meatal stenosis. Glandular dehiscence occurred in one patient (5%) in group B. There was no skin wound infection in both groups. Conclusion The PRF membrane may be a promising method as a coverage layer over the urethroplasty aiming to reduce the fistula rate after the repair. A larger comparative study is needed to evaluate the efficacy of PRF membranes in promoting wound healing.

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The Use of Autologous Platelet Rich Fibrin Membrane as a Second Layer in Snodgrass Repair of Distal Hypospadias

Cited by 2 publications

References 0 publications

Use of an Autologous Platelet-Rich Concentrate in Hypospadias Repair: A Systematic Review and Meta analysis

Use of an Autologous Platelet-Rich Concentrate in Hypospadias Repair: A Systematic Review and Meta analysis

The use of an autologous platelet-rich fibrin membrane in urethroplasty for cases of distal hypospadias

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