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Clinical results of one-stage urethroplasty with parameatal foreskin flap for hypospadias.

We investigated the usefulness of one-stage urethroplasty by the parameatal foreskin flap method (OUPF procedure), which is useful for repairing all types of hypospadias. Between June 1992 and March 2001, the OUPF procedure was performed on 18 patients with hypospadias: 10 patients with distal and 8 with proximal hypospadias. The follow-up periods ranged from 33-75 months, with an average of 52 months. The duration of surgery, the catheter indwelling period, and the postoperative complications of each patient were analyzed. The median age of the patients at the time of surgery was 3 years and 8 months. The length of surgery for OUPF II ranged from 150-230 min (average 186 min), and from 190-365 min (average 267 min) for OUPF IV. Postoperative complications were confirmed in 3 of the 18 patients (16.6%). Two patients had fistulas, and one had a meatal regression. The fistulas were successfully closed by the simple multilayered closure method. After adopting DuoDerm dressings instead of elastic bandages for protection of the wound, no fistulization occurred. DuoDerm dressings are useful in the healing of wounds without complications. To date, the longest follow-up period has been 75 months, and during that time there have been no late complications such as urethral stenosis or penile curvature. OUPF is a useful method in the treatment of hypospadias with a low incidence of early and late complications.

Adolescent↗

Temporary prosthetic fitting for below-knee amputation.

The problems encountered in fitting and using the permanent below-knee prosthesis in developing countries are the high price of the prosthesis, inadequate fitting and lack of proper rehabilitation. In Turkey, the preferred treatment of the stump post-operatively is by the soft dressing method with bandaging for maturation and shrinkage. Generally, the application of the permanent prosthesis is in the sixth month post-operatively. Since in patellar-tendon-bearing (PTB) sockets, stumps have to withstand high pressures in limited areas, the PTB socket can only tolerate small volume changes in the stump. For this reason bandaging over a long period may be insufficient for adequate stump shrinkage and amputees will need another below-knee prosthesis, which most of them cannot afford after only a few weeks use. In the authors' clinic, 19 amputees were fitted with simple, effective and inexpensive temporary prostheses following either conventional immediate post-operative dressing or the soft dressing method. The temporary prosthesis is worn for two months. It produces fast stump shrinkage, helps maturation and permits ambulatory discharge even in bilateral amputees. For economical reasons, only eight of nineteen patients were fitted with permanent prostheses, all wearing them successfully without the necessity of further rehabilitation.

Adult↗

Effects of a proprietary topical medication on wound healing and collagen deposition in horses.

Full-thickness skin wounds were created on the dorsum of both metacarpi in 8 horses. Three topical treatment regimens were studied. All wounds were bandaged with a nonadherent dressing, which was held in place with a snug elastic wrap. Group-A wounds were treated with a proprietary topical wound medication that consisted of a spray and an ointment. Group-B wounds were treated with the same regimen, except the putative active ingredients in the ointment were omitted. Group-C wounds were treated with a dry nonadherent bandage only. Wound dressings were changed every day and the limbs were photographed every other day until the wounds were healed. Specimens of normal skin and biopsy specimens of healed wounds were examined histologically and were assayed for hydroxyproline content. Wound healing measurements quantitated for each wound were number of days to healing, maximal wound size attained, day wound contraction commenced, day epithelium first noticed, rate of wound contraction, final wound size, and fraction of the wound that healed by contraction. The cosmetic appearance of the healed wounds was also graded. Significant differences were not noticed in hydroxyproline content, histologic appearance, or any of the wound healing measurements between treatment groups. The cosmetic appearance of healed group-A and -B wounds was significantly better than the appearance of group-C wounds. The topical treatment regimens studied neither enhanced nor inhibited wound healing in this study.

Administration, Topical↗

[Wound coverage following dermabrasion].

A simple, easy and effective wound closure following dermabrasion was carried out by fixation of Transite over the Epidermal-cutaneous defect and Allevyn over this Mesh-Graft-Like biologic dressing. Transite shows very little adherence to the wound surface. It is not damaging the wound at removal. The dressing removal is painless.

Bandages↗