Ann Plast Reconstr Surg | Volume 3, Issue 2 | Research Article | Open Access

Comparative Study between Adrenaline Injection and Bipolar Electrocautery in Proximal Hypospadias Repair

Saber M Abdelmaksoud*

Department of Plastic Surgery, Port Said University, Egypt

*Correspondance to: Saber M Abdelmaksoud 

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Abstract

Background &
Aim: There are several techniques to repair hypospadias. Hemostasis is very important for meticulous surgical repair to achieve the best cosmetic and functional outcome and also to prevent complications as bleeding, hematoma, wound dehiscence and fistula formation because this area is very vascular. Hemostasis in hypospadias can be achieved by different methods as tourniquet, electrocautery, and vasoconstrictive agents as adrenaline. The aim of this study is to compare between the effect of Adrenaline-Xylocaine injection (Adrenaline 1/200000-Xylocaine 1%) and bipolar electrocautery for hemostasis in proximal hypospadias (proximal shaft, penoscrotal and perineal hypospadias). Patients and
Methods: This study included 40 uncircumcised boys with proximal hypospadias without any attempt of surgical repair. Patients randomized into 2 groups, Group A: Included 20 boys in whom the bipolar diathermy was used to achieve hemostasis during repair, and Group B: Included 20 boys in whom Adrenaline-Xylocaine injection (Adrenaline 1/200000-Xylocaine 1%) was injected in the surgical incision site in the ventral aspect of the penis and anterior aspect of scrotum to achieve hemostasis during repair. The data were collected, organized, and tabulated according to age, operative time, early postoperative bleeding, wound dehiscence and flap necrosis, fistula and cosmetic appearance.
Results: The Adrenaline-Xylocaine injection in the surgical site is more effective than bipolar diathermy in achieving hemostasis (p=0.039), reducing the postoperative incidence of hematoma (p=0.04), and fistula formation (p=0.0088), and helping in meticulous repair, but with more operative time than bipolar one because waiting for adrenaline action to fulfill its vasoconstrictive action.
Conclusion: Although epinephrine injection has previously been shown to have deleterious effects on tissue repair, in the present clinical practice, epinephrine injection was found to minimize operative bleeding without significant harmful effects on the postoperative outcomes. Therefore, it could be considered as a safe and effective method with which to prepare a bloodless field during hypospadias surgery.

Keywords:

Adrenaline injection; Bipolar electrocautery; Proximal hypospadias repair

Citation:

Abdelmaksoud SM. Comparative Study between Adrenaline Injection and Bipolar Electrocautery in Proximal Hypospadias Repair. Ann Plast Reconstr Surg. 2019;3(2):1028.

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