Mercurochrome as an adjunct to local preoperative preparation in children undergoing hypospadias repair
TL;DR: To determine whether the local application of mercurochrome over genital skin before surgery, in addition to soap/water scrubs, can help to decrease the incidence of infection patients undergoing hypospadias repair, and therebyThe incidence of fistula formation.
Abstract: Objective To determine whether the local application of mercurochrome over genital skin before surgery, in addition to soap/water scrubs, can help to decrease the incidence of infection patients undergoing hypospadias repair, and thereby the incidence of fistula formation. Patients and methods The study comprised 44 consecutive boys undergoing primary or repeat surgery for hypospadias between October 1999 and April 2000. They were arbitrarily divided into two groups; group 1 received a conventional local scrub with soap/water 48 h before surgery and group 2, a conventional local scrub with soap/water was followed by a local application of 2% mercurochrome for 48 h before surgery. Both groups were comparable in age, location of the meatus and stage of repair. All patients were exposed to similar conditions during and after surgery. Urine, skin and wound swabs taken before during and after surgery were assessed microbiologically, using standard precautions. The incidence of infection and complications was then compared. Results Mercurochrome significantly decreased local infection, especially before surgery, but its effect in decreasing fistula formation, although appreciable, was not statistically significant. Conclusion The local application of mercurochrome after a soap/water scrub for at least 48 h before surgery is a simple, economic and effective means to decrease postoperative wound infection. Future studies are needed, keeping other determinants of fistula formation constant, to evaluate its role in decreasing fistula formation in patients undergoing hypospadias repair.
TL;DR: Most acute complications in hypospadias surgery can be prevented with adherence to principles of plastic and microsurgery, meticulous preoperative planning, and judicious postoperative care.
Abstract: Purpose: Complications in hypospadias surgery are higher than other reconstructive procedures. The incidence of complications can be reduced if proper preventive measures are taken. The review aims to highlight incidences, causes, and preventive measures of acute complications of hypospadias repair. Materials and Methods: Literature reports were reviewed in Pubmed by giving the key word acute complications of hypospadias repair, wound infection, wound dehiscence, flap necrosis, edema, penile torsion, urethral fistula, bleeding and hematoma and urethral stents problems. Summaries of all articles were reviewed with full text of relevant article and results were analyzed. Results: Besides mentioning the complications of hypospadias repair in individual articles on the subject, we did not come across any separate article on this subject in the published English literature. Fistula is the commonest complication followed by edema and penile torsion. Conclusions: Most acute complications can be prevented with adherence to principles of plastic and microsurgery, meticulous preoperative planning, and judicious postoperative care. Deviation from these principles may lead to disaster and even failure of the repair. The aim in hypospadias surgery should be following these principles and bring down the complication rates <5% in distal hypospadias and <10% in proximal hypospadias.
TL;DR: The most common early complication is edema and it can be reduced by meticulous handling of tissue and use of loupe magnification, the operative time is reduced to less than 60 minutes to prevent prolonged use of tourniquet.
Abstract: Hypospadias is a congenital anomaly in which due to the incomplete fusion of urethral folds the meatus opens on the ventral surface of the penis. It s the most common congenital malformation of the urethra with the prevalence of 1 in 200-300 live male births. The early complications are edema, hematoma and wound infection which occur within one week after the 1st stage of the procedure. The aim of the study is to determine the frequency of early complications of two staged AB repair. The rationale of the study is that if the early complications rate of two staged AB repair comes out significantly lower than other studies then it will help reconsider the existing guidelines of hypospadias surgery. MATERIAL AND METHODS: This study was conducted at Plastic and reconstructive unit Hayatabad Medical Complex Peshawar for the period of 24 months (from August 2011 to July 2013). The total sample size was 369 patients. More over this was a descriptive cross-sectional study in which non-probability consecutive sampling technique was used. RESULTS: In this study mean age was 3 years with standard deviation ± 1.24. All the patients were male in which 35% patients had edema, 4% patients had hematoma, and 2% patients had wound infection. CONCLUSION: The most common early complication is edema and it can be reduced by meticulous handling of tissue and use of loupe magnification, the operative time is reduced to less than 60 minutes to prevent prolonged use of tourniquet.
TL;DR: In this paper, the efficacy of pre-and post-operative showering for preventing surgical site infections (SSIs) and urethrocutaneous fistula after hypospadias surgery was reported.
Abstract: Purpose: We report the efficacy of pre- and post-operative showering for preventing surgical site infections (SSIs) and urethrocutaneous fistula after hypospadias surgery. Materials and Methods: In 2006, standardised pre- and postoperative showering was introduced for hypospadias patients. Showering involves washing the genitals and groin 2 h preoperatively as well as immediately after the removal of a stent postoperatively. Data from 520 procedures performed on 376 hypospadias patients by a single surgeon from 1996 to 2015 were collected prospectively. The shower (S) group comprised 258 patients (372 procedures) and the nonshower group comprised 118 patients (148 procedures). Management protocols were identical for two groups. Results: Patient demographics were similar. SSIs were significantly less in the S group (0% vs. 2.0%; P
TL;DR: In this article, the authors identify the bacterial flora present before and after cleansing of the prepuce as well as 7'd after hypospadias surgery with foreskin reconstruction, which is an increasingly preferred option for the management of this common condition.
Abstract: Hypospadias surgery with foreskin reconstruction is an increasingly preferred option for the management of this common condition The objective of this study was to identify the bacterial flora present before and after cleansing of the prepuce as well as 7 d after surgery Sixty-three boys aged between 12–14 months, with primary distal hypospadias undergoing tubularized incised plate repair, were recruited between October 2013 and April 2014 Microbiological swabs were taken pre- and post-operatively to identify organisms present under their foreskin at the time of surgery and compared with organisms present 7 d post-operatively at the time of dressing removal A parent reported wound infection tool was used to explore parents' perception and management of their son's wound 4 weeks following surgery Bacterial colonization of the penis was common Routine cleansing with an alcoholic chlorhexidine solution reduced bacterial flora in 82% of boys with a positive preoperative swab result Post-operative colonization of the penis was found in 93% of patients, wound dressing colonization was common Two parents' reported concerns regarding their son's wound healing Topical cleansing at the time of surgery is effective in reducing the number of organisms present under the foreskin Despite recolonization 7 d after surgery, clinical infection remains uncommon Complication rate 12 months after surgery was very low <2%
TL;DR: Although there are a number of germicidal agents commercially available, effective antisepsis and disinfection can be achieved through use of a few effective, yet safe germicides.
Abstract: Antiseptics and disinfectants play an important role in microbial control in both the veterinary patient and hospital. Selection of antiseptics and disinfectants should be based on knowledge of their characteristics. Antiseptics should exert a sustained effect against microorganisms without causing tissue damage. Disinfectants destroy disease-producing microorganisms on inanimate objects, but they lack the efficacy achieved by sterilization procedures. The key to proper use of antiseptics and disinfectants is using the proper germicidal agent under conditions that maximize success and minimize complications.
01 Jan 1997
TL;DR: Two outbreaks of Mycobacterium chelonei subsp.
Abstract: We report on two outbreaks of Mycobacterium chelonei subsp. abscessus cutaneous infections, which occurred between June 1974 and April 1975 in a series of 24 patients (15 studied bacteriologically) subjected to venous stripping for varicose veins. The source of infection was the aqueous solution of merbromin used in presurgical care.