Use of Acellular Dermal Matrix for Urethroplasty Coverage in Proximal Hypospadias Repair: a Pilot Study
Introduction The complication rates of proximal hypospadias, especially fistula, are much higher than those of distal hypospadias. Urethral coverage is an effective method for reducing fistulas. Acellular dermal matrix (ADM) has been shown to exhibit structural compatibility and biocompatibility, bo...
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| Veröffentlicht in: | Advances in therapy 2020-04, Vol.37 (4), p.1425-1435 |
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| creator | Lin, Defu Wang, Guannan Song, Hongcheng Qu, Yanchao Liu, Pei Liang, Haiyan Xu, Shuai Chen, Shuofan Zhang, Weiping Zhao, Yannan Chen, Bing Sun, Ning |
| description | Introduction
The complication rates of proximal hypospadias, especially fistula, are much higher than those of distal hypospadias. Urethral coverage is an effective method for reducing fistulas. Acellular dermal matrix (ADM) has been shown to exhibit structural compatibility and biocompatibility, both of which promote tissue healing.
Methods
The present non-randomized study evaluated the efficiency, feasibility, and safety of using ADM for urethroplasty coverage in patients with proximal hypospadias. This prospective study enrolled 35 patients (age range 15–60 months) with proximal hypospadias who underwent operation between September 2018 and March 2019 at Beijing Children’s Hospital (Beijing, China). Urethroplasties were performed by the transverse preputial island flap (TPIF) technique. ADM was applied and sutured over the urethroplasty as an additional covering layer. Patient outcomes were compared with those of 80 non-matched control patients with proximal hypospadias who underwent the same procedure, with dartos as a covering layer.
Results
During a median follow-up of 11.56 months (range 9–15 months), urethral fistula occurred in six patients (17.1%) in the ADM group and 28 patients (35%) in the dartos group. Superficial wound infection was observed in six patients (17.1%) in the ADM group and 10 patients (12.5%) in the dartos group. One patient in the ADM group had diverticulum, compared with five patients (6.25%) in the dartos group. Meatal stenosis and urethral stricture were observed in four patients (11.4%) in the ADM group and six patients (7.5%) in the dartos group; all of these complications were treated conservatively. No glans dehiscence was observed in either group.
Conclusion
Use of ADM may be a safe and efficient covering technique to provide an additional coverage layer for proximal hypospadias repair, thereby reducing the incidence of fistula formation, especially among patients who have poor-quality covering materials. |
| doi_str_mv | 10.1007/s12325-020-01254-9 |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_miscellaneous_2356616284</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>2356616284</sourcerecordid><originalsourceid>FETCH-LOGICAL-c446t-fcbd40fb8825572436e0a4a0b589a0094ef01d4421e08f4db5972ff21bd2315f3</originalsourceid><addsrcrecordid>eNqNkUFv1DAQhSMEotvCH-CAfERCgbFjJw4HpCoUilREBazEzXKS8dZVNg62U7r_Hm9TVnBBWLJ88Pdmnt7LsmcUXlGA6nWgrGAiBwY5UCZ4Xj_IVlSWIk-XPcxWUHGas0J-P8qOQ7iGRFZCPs6OCgYlk5Svss06IHGGnHY4DPOgPXmHfqsH8klHb2-JcZ6sPcYr76ZBh7gjjbtBrzdI7Eguvbu1e_p8N7kw6d7qQL7gpK1_QzS5tIOL5Guc-92T7JHRQ8Cn9-9Jtn5_9q05zy8-f_jYnF7kHedlzE3X9hxMKyUTomK8KBE019AKWWuAmqMB2nPOKII0vG9FXTFjGG17VlBhipPs7TJ3mtst9h2O0etBTT7Z9DvltFV__4z2Sm3cjaooh6oo04AX9wO8-zFjiGprwz4cPaKbg2KFKEua0uMJZQvaeReCR3NYQ0HtG1JLQyrlru4aUnUSPf_T4EHyu5IEvFyAn9g6EzqLY4cHDAAELamEu0MTLf-fbmzU0bqxcfMYk7RYpCHh4wa9unazH1M7__L_C5aFvgI</addsrcrecordid><sourcetype>Open Access Repository</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>2356616284</pqid></control><display><type>article</type><title>Use of Acellular Dermal Matrix for Urethroplasty Coverage in Proximal Hypospadias Repair: a Pilot Study</title><source>MEDLINE</source><source>Springer Online Journals Complete</source><source>Web of Science - Science Citation Index Expanded - 2020<img src="https://exlibris-pub.s3.amazonaws.com/fromwos-v2.jpg" /></source><creator>Lin, Defu ; Wang, Guannan ; Song, Hongcheng ; Qu, Yanchao ; Liu, Pei ; Liang, Haiyan ; Xu, Shuai ; Chen, Shuofan ; Zhang, Weiping ; Zhao, Yannan ; Chen, Bing ; Sun, Ning</creator><creatorcontrib>Lin, Defu ; Wang, Guannan ; Song, Hongcheng ; Qu, Yanchao ; Liu, Pei ; Liang, Haiyan ; Xu, Shuai ; Chen, Shuofan ; Zhang, Weiping ; Zhao, Yannan ; Chen, Bing ; Sun, Ning</creatorcontrib><description>Introduction
The complication rates of proximal hypospadias, especially fistula, are much higher than those of distal hypospadias. Urethral coverage is an effective method for reducing fistulas. Acellular dermal matrix (ADM) has been shown to exhibit structural compatibility and biocompatibility, both of which promote tissue healing.
Methods
The present non-randomized study evaluated the efficiency, feasibility, and safety of using ADM for urethroplasty coverage in patients with proximal hypospadias. This prospective study enrolled 35 patients (age range 15–60 months) with proximal hypospadias who underwent operation between September 2018 and March 2019 at Beijing Children’s Hospital (Beijing, China). Urethroplasties were performed by the transverse preputial island flap (TPIF) technique. ADM was applied and sutured over the urethroplasty as an additional covering layer. Patient outcomes were compared with those of 80 non-matched control patients with proximal hypospadias who underwent the same procedure, with dartos as a covering layer.
Results
During a median follow-up of 11.56 months (range 9–15 months), urethral fistula occurred in six patients (17.1%) in the ADM group and 28 patients (35%) in the dartos group. Superficial wound infection was observed in six patients (17.1%) in the ADM group and 10 patients (12.5%) in the dartos group. One patient in the ADM group had diverticulum, compared with five patients (6.25%) in the dartos group. Meatal stenosis and urethral stricture were observed in four patients (11.4%) in the ADM group and six patients (7.5%) in the dartos group; all of these complications were treated conservatively. No glans dehiscence was observed in either group.
Conclusion
Use of ADM may be a safe and efficient covering technique to provide an additional coverage layer for proximal hypospadias repair, thereby reducing the incidence of fistula formation, especially among patients who have poor-quality covering materials.</description><identifier>ISSN: 0741-238X</identifier><identifier>EISSN: 1865-8652</identifier><identifier>DOI: 10.1007/s12325-020-01254-9</identifier><identifier>PMID: 32062814</identifier><language>eng</language><publisher>Cheshire: Springer Healthcare</publisher><subject><![CDATA[Acellular Dermis ; Cardiology ; Child, Preschool ; China ; Endocrinology ; Humans ; Hypospadias - surgery ; Infant ; Internal Medicine ; Life Sciences & Biomedicine ; Male ; Medicine ; Medicine & Public Health ; Medicine, Research & Experimental ; Oncology ; Original Research ; Pharmacology & Pharmacy ; Pharmacology/Toxicology ; Pilot Projects ; Prospective Studies ; Research & Experimental Medicine ; Rheumatology ; Science & Technology ; Surgical Flaps - surgery ; Treatment Outcome ; Urethra - surgery ; Urinary Fistula - etiology ; Urinary Fistula - prevention & control ; Urologic Surgical Procedures, Male - adverse effects ; Urologic Surgical Procedures, Male - methods ; Wound Healing - physiology]]></subject><ispartof>Advances in therapy, 2020-04, Vol.37 (4), p.1425-1435</ispartof><rights>The Author(s) 2020</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>true</woscitedreferencessubscribed><woscitedreferencescount>10</woscitedreferencescount><woscitedreferencesoriginalsourcerecordid>wos000516180000001</woscitedreferencesoriginalsourcerecordid><citedby>FETCH-LOGICAL-c446t-fcbd40fb8825572436e0a4a0b589a0094ef01d4421e08f4db5972ff21bd2315f3</citedby><cites>FETCH-LOGICAL-c446t-fcbd40fb8825572436e0a4a0b589a0094ef01d4421e08f4db5972ff21bd2315f3</cites><orcidid>0000-0002-3443-6991</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://link.springer.com/content/pdf/10.1007/s12325-020-01254-9$$EPDF$$P50$$Gspringer$$Hfree_for_read</linktopdf><linktohtml>$$Uhttps://link.springer.com/10.1007/s12325-020-01254-9$$EHTML$$P50$$Gspringer$$Hfree_for_read</linktohtml><link.rule.ids>230,315,781,785,886,27929,27930,28253,41493,42562,51324</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/32062814$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Lin, Defu</creatorcontrib><creatorcontrib>Wang, Guannan</creatorcontrib><creatorcontrib>Song, Hongcheng</creatorcontrib><creatorcontrib>Qu, Yanchao</creatorcontrib><creatorcontrib>Liu, Pei</creatorcontrib><creatorcontrib>Liang, Haiyan</creatorcontrib><creatorcontrib>Xu, Shuai</creatorcontrib><creatorcontrib>Chen, Shuofan</creatorcontrib><creatorcontrib>Zhang, Weiping</creatorcontrib><creatorcontrib>Zhao, Yannan</creatorcontrib><creatorcontrib>Chen, Bing</creatorcontrib><creatorcontrib>Sun, Ning</creatorcontrib><title>Use of Acellular Dermal Matrix for Urethroplasty Coverage in Proximal Hypospadias Repair: a Pilot Study</title><title>Advances in therapy</title><addtitle>Adv Ther</addtitle><addtitle>ADV THER</addtitle><addtitle>Adv Ther</addtitle><description>Introduction
The complication rates of proximal hypospadias, especially fistula, are much higher than those of distal hypospadias. Urethral coverage is an effective method for reducing fistulas. Acellular dermal matrix (ADM) has been shown to exhibit structural compatibility and biocompatibility, both of which promote tissue healing.
Methods
The present non-randomized study evaluated the efficiency, feasibility, and safety of using ADM for urethroplasty coverage in patients with proximal hypospadias. This prospective study enrolled 35 patients (age range 15–60 months) with proximal hypospadias who underwent operation between September 2018 and March 2019 at Beijing Children’s Hospital (Beijing, China). Urethroplasties were performed by the transverse preputial island flap (TPIF) technique. ADM was applied and sutured over the urethroplasty as an additional covering layer. Patient outcomes were compared with those of 80 non-matched control patients with proximal hypospadias who underwent the same procedure, with dartos as a covering layer.
Results
During a median follow-up of 11.56 months (range 9–15 months), urethral fistula occurred in six patients (17.1%) in the ADM group and 28 patients (35%) in the dartos group. Superficial wound infection was observed in six patients (17.1%) in the ADM group and 10 patients (12.5%) in the dartos group. One patient in the ADM group had diverticulum, compared with five patients (6.25%) in the dartos group. Meatal stenosis and urethral stricture were observed in four patients (11.4%) in the ADM group and six patients (7.5%) in the dartos group; all of these complications were treated conservatively. No glans dehiscence was observed in either group.
Conclusion
Use of ADM may be a safe and efficient covering technique to provide an additional coverage layer for proximal hypospadias repair, thereby reducing the incidence of fistula formation, especially among patients who have poor-quality covering materials.</description><subject>Acellular Dermis</subject><subject>Cardiology</subject><subject>Child, Preschool</subject><subject>China</subject><subject>Endocrinology</subject><subject>Humans</subject><subject>Hypospadias - surgery</subject><subject>Infant</subject><subject>Internal Medicine</subject><subject>Life Sciences & Biomedicine</subject><subject>Male</subject><subject>Medicine</subject><subject>Medicine & Public Health</subject><subject>Medicine, Research & Experimental</subject><subject>Oncology</subject><subject>Original Research</subject><subject>Pharmacology & Pharmacy</subject><subject>Pharmacology/Toxicology</subject><subject>Pilot Projects</subject><subject>Prospective Studies</subject><subject>Research & Experimental Medicine</subject><subject>Rheumatology</subject><subject>Science & Technology</subject><subject>Surgical Flaps - surgery</subject><subject>Treatment Outcome</subject><subject>Urethra - surgery</subject><subject>Urinary Fistula - etiology</subject><subject>Urinary Fistula - prevention & control</subject><subject>Urologic Surgical Procedures, Male - adverse effects</subject><subject>Urologic Surgical Procedures, Male - methods</subject><subject>Wound Healing - physiology</subject><issn>0741-238X</issn><issn>1865-8652</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2020</creationdate><recordtype>article</recordtype><sourceid>C6C</sourceid><sourceid>AOWDO</sourceid><sourceid>EIF</sourceid><recordid>eNqNkUFv1DAQhSMEotvCH-CAfERCgbFjJw4HpCoUilREBazEzXKS8dZVNg62U7r_Hm9TVnBBWLJ88Pdmnt7LsmcUXlGA6nWgrGAiBwY5UCZ4Xj_IVlSWIk-XPcxWUHGas0J-P8qOQ7iGRFZCPs6OCgYlk5Svss06IHGGnHY4DPOgPXmHfqsH8klHb2-JcZ6sPcYr76ZBh7gjjbtBrzdI7Eguvbu1e_p8N7kw6d7qQL7gpK1_QzS5tIOL5Guc-92T7JHRQ8Cn9-9Jtn5_9q05zy8-f_jYnF7kHedlzE3X9hxMKyUTomK8KBE019AKWWuAmqMB2nPOKII0vG9FXTFjGG17VlBhipPs7TJ3mtst9h2O0etBTT7Z9DvltFV__4z2Sm3cjaooh6oo04AX9wO8-zFjiGprwz4cPaKbg2KFKEua0uMJZQvaeReCR3NYQ0HtG1JLQyrlru4aUnUSPf_T4EHyu5IEvFyAn9g6EzqLY4cHDAAELamEu0MTLf-fbmzU0bqxcfMYk7RYpCHh4wa9unazH1M7__L_C5aFvgI</recordid><startdate>20200401</startdate><enddate>20200401</enddate><creator>Lin, Defu</creator><creator>Wang, Guannan</creator><creator>Song, Hongcheng</creator><creator>Qu, Yanchao</creator><creator>Liu, Pei</creator><creator>Liang, Haiyan</creator><creator>Xu, Shuai</creator><creator>Chen, Shuofan</creator><creator>Zhang, Weiping</creator><creator>Zhao, Yannan</creator><creator>Chen, Bing</creator><creator>Sun, Ning</creator><general>Springer Healthcare</general><general>Springer Nature</general><scope>C6C</scope><scope>AOWDO</scope><scope>BLEPL</scope><scope>DTL</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope><scope>5PM</scope><orcidid>https://orcid.org/0000-0002-3443-6991</orcidid></search><sort><creationdate>20200401</creationdate><title>Use of Acellular Dermal Matrix for Urethroplasty Coverage in Proximal Hypospadias Repair: a Pilot Study</title><author>Lin, Defu ; Wang, Guannan ; Song, Hongcheng ; Qu, Yanchao ; Liu, Pei ; Liang, Haiyan ; Xu, Shuai ; Chen, Shuofan ; Zhang, Weiping ; Zhao, Yannan ; Chen, Bing ; Sun, Ning</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c446t-fcbd40fb8825572436e0a4a0b589a0094ef01d4421e08f4db5972ff21bd2315f3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2020</creationdate><topic>Acellular Dermis</topic><topic>Cardiology</topic><topic>Child, Preschool</topic><topic>China</topic><topic>Endocrinology</topic><topic>Humans</topic><topic>Hypospadias - surgery</topic><topic>Infant</topic><topic>Internal Medicine</topic><topic>Life Sciences & Biomedicine</topic><topic>Male</topic><topic>Medicine</topic><topic>Medicine & Public Health</topic><topic>Medicine, Research & Experimental</topic><topic>Oncology</topic><topic>Original Research</topic><topic>Pharmacology & Pharmacy</topic><topic>Pharmacology/Toxicology</topic><topic>Pilot Projects</topic><topic>Prospective Studies</topic><topic>Research & Experimental Medicine</topic><topic>Rheumatology</topic><topic>Science & Technology</topic><topic>Surgical Flaps - surgery</topic><topic>Treatment Outcome</topic><topic>Urethra - surgery</topic><topic>Urinary Fistula - etiology</topic><topic>Urinary Fistula - prevention & control</topic><topic>Urologic Surgical Procedures, Male - adverse effects</topic><topic>Urologic Surgical Procedures, Male - methods</topic><topic>Wound Healing - physiology</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Lin, Defu</creatorcontrib><creatorcontrib>Wang, Guannan</creatorcontrib><creatorcontrib>Song, Hongcheng</creatorcontrib><creatorcontrib>Qu, Yanchao</creatorcontrib><creatorcontrib>Liu, Pei</creatorcontrib><creatorcontrib>Liang, Haiyan</creatorcontrib><creatorcontrib>Xu, Shuai</creatorcontrib><creatorcontrib>Chen, Shuofan</creatorcontrib><creatorcontrib>Zhang, Weiping</creatorcontrib><creatorcontrib>Zhao, Yannan</creatorcontrib><creatorcontrib>Chen, Bing</creatorcontrib><creatorcontrib>Sun, Ning</creatorcontrib><collection>Springer Nature OA/Free Journals</collection><collection>Web of Science - Science Citation Index Expanded - 2020</collection><collection>Web of Science Core Collection</collection><collection>Science Citation Index Expanded</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><collection>PubMed Central (Full Participant titles)</collection><jtitle>Advances in therapy</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Lin, Defu</au><au>Wang, Guannan</au><au>Song, Hongcheng</au><au>Qu, Yanchao</au><au>Liu, Pei</au><au>Liang, Haiyan</au><au>Xu, Shuai</au><au>Chen, Shuofan</au><au>Zhang, Weiping</au><au>Zhao, Yannan</au><au>Chen, Bing</au><au>Sun, Ning</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Use of Acellular Dermal Matrix for Urethroplasty Coverage in Proximal Hypospadias Repair: a Pilot Study</atitle><jtitle>Advances in therapy</jtitle><stitle>Adv Ther</stitle><stitle>ADV THER</stitle><addtitle>Adv Ther</addtitle><date>2020-04-01</date><risdate>2020</risdate><volume>37</volume><issue>4</issue><spage>1425</spage><epage>1435</epage><pages>1425-1435</pages><issn>0741-238X</issn><eissn>1865-8652</eissn><abstract>Introduction
The complication rates of proximal hypospadias, especially fistula, are much higher than those of distal hypospadias. Urethral coverage is an effective method for reducing fistulas. Acellular dermal matrix (ADM) has been shown to exhibit structural compatibility and biocompatibility, both of which promote tissue healing.
Methods
The present non-randomized study evaluated the efficiency, feasibility, and safety of using ADM for urethroplasty coverage in patients with proximal hypospadias. This prospective study enrolled 35 patients (age range 15–60 months) with proximal hypospadias who underwent operation between September 2018 and March 2019 at Beijing Children’s Hospital (Beijing, China). Urethroplasties were performed by the transverse preputial island flap (TPIF) technique. ADM was applied and sutured over the urethroplasty as an additional covering layer. Patient outcomes were compared with those of 80 non-matched control patients with proximal hypospadias who underwent the same procedure, with dartos as a covering layer.
Results
During a median follow-up of 11.56 months (range 9–15 months), urethral fistula occurred in six patients (17.1%) in the ADM group and 28 patients (35%) in the dartos group. Superficial wound infection was observed in six patients (17.1%) in the ADM group and 10 patients (12.5%) in the dartos group. One patient in the ADM group had diverticulum, compared with five patients (6.25%) in the dartos group. Meatal stenosis and urethral stricture were observed in four patients (11.4%) in the ADM group and six patients (7.5%) in the dartos group; all of these complications were treated conservatively. No glans dehiscence was observed in either group.
Conclusion
Use of ADM may be a safe and efficient covering technique to provide an additional coverage layer for proximal hypospadias repair, thereby reducing the incidence of fistula formation, especially among patients who have poor-quality covering materials.</abstract><cop>Cheshire</cop><pub>Springer Healthcare</pub><pmid>32062814</pmid><doi>10.1007/s12325-020-01254-9</doi><tpages>11</tpages><orcidid>https://orcid.org/0000-0002-3443-6991</orcidid><oa>free_for_read</oa></addata></record> |
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| subjects | Acellular Dermis Cardiology Child, Preschool China Endocrinology Humans Hypospadias - surgery Infant Internal Medicine Life Sciences & Biomedicine Male Medicine Medicine & Public Health Medicine, Research & Experimental Oncology Original Research Pharmacology & Pharmacy Pharmacology/Toxicology Pilot Projects Prospective Studies Research & Experimental Medicine Rheumatology Science & Technology Surgical Flaps - surgery Treatment Outcome Urethra - surgery Urinary Fistula - etiology Urinary Fistula - prevention & control Urologic Surgical Procedures, Male - adverse effects Urologic Surgical Procedures, Male - methods Wound Healing - physiology |
| title | Use of Acellular Dermal Matrix for Urethroplasty Coverage in Proximal Hypospadias Repair: a Pilot Study |
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