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Surgical evaluation of autologous platelets-rich fibrin membrane as a coverage layer in repair of urethro-cutaneous fistula after hypospadias surgeries: a randomized control trial.
Mahmoud Tarek, Alaa Aly, Ahmed kadri
Cairo University Faculty of Medicine, Pediatric Surgical Division, Cairo University Specialized Pediatric Hospital, Egypt
Background: It has recently been reported that the use of platelet-rich fibrin (PRF) as an extra layer over the urethroplasty has been related to a considerable reduction in fistula rates after hypospadias surgeries, PRF coverage is a new covering technique after urethroplasty believed to enhance healing and resist infection. Due to the lack of evidence supporting the usage of PRF in urethrocutaneous fistula (UCF) repair, we conducted this study to evaluate the efficacy of PRF in patients with UCF in minimizing incidence rate of recurrent fistula.
Methods: We conducted a randomized controlled study on patients with distal fistula after hypospadias repair. Patients were randomly divided into two groups to undergo local dartos (control group) or PRF (study group) as a first coverage layer over repair.
Results: In the present study, we included 37 patients; 20 patients underwent local dartos coverage, and 17 patients underwent PRF. The mean age was 22.45 ± 15.35 (range 11–56) months for the study group and 20.6 ± 14.5 (range 6–45) months for the control group. The incidence of recurrent UCF was 11.7% in the study group (two patients) while the incidence was 30% (six patients) in the control group (p =0.246).
Conclusion: UCF surgery may benefit from the use of PRF as a supportive tissue that promotes wound healing, angiogenesis, and tissue restoration. We believe that the use of PRF as a new approach for UCF repair should be investigated further via clinical studies.