1
|
Fahmy MAB, Sabra TA, Abdelmohsen SM. Management of penile post-circumcision ischemia by pentoxifylline infusion and hyperbaric oxygen therapy. BMC Urol 2023; 23:117. [PMID: 37438810 DOI: 10.1186/s12894-023-01284-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2022] [Accepted: 06/28/2023] [Indexed: 07/14/2023] Open
Abstract
BACKGROUND Post-circumcision penile ischemia is a devastating complication. We will present our experience in managing children with various forms of penile ischemia. MATERIALS AND METHODS This cohort prospective observational and interventional study was performed on all male children with post-circumcision penile ischemia between April 2017 and October 2021. A designed and approved protocol includes a combination of early pentoxifylline infusion, hyperbaric oxygen inhalation, early catheterization, and appropriate surgical debridement were applied for patients with deep ischemia 11/23, mainly the necrotic skin and subcutaneous tissues. Data of patient age, anesthesia method, monopolar diathermy usage, early presentation and positive wound culture were collected and analyzed statistically. RESULTS During the study period 3,382 children were circumcised for non-medical reasons; 23 children were diagnosed with penile ischemia (0.7%), among other complications (9%). Most of the penile ischemia is associated with the use of monopolar diathermy (74%). The use of compressive wound dressing to control post-circumcision bleeding and infections is also responsible for ischemia in 52.2% and 43.5% of the cases. Inexperienced physicians were commonly responsible for ischemia (73.9%). Patients managed at first 24 h had better outcomes than those who were presented later (p = 0.001). CONCLUSION In children with post-circumcision penile ischemia, a combination of hyperbaric oxygen therapy and pentoxifylline is especially effective for patients with skin and facial necrosis, this management reduces penile tissue loss.
Collapse
Affiliation(s)
- Mohamed A Baky Fahmy
- Faculty of Medicine, Pediatric Surgery Department, Al-Azhar University, Cairo, Egypt.
| | | | - Sarah Magdy Abdelmohsen
- Lecturer of Pediatric Surgery, Faculty of Medicine, Pediatric Surgery Unit, Aswan University, Aswan, Egypt
| |
Collapse
|
2
|
Bi M, Li D, Zhang J. Role of curcumin in ischemia and reperfusion injury. Front Pharmacol 2023; 14:1057144. [PMID: 37021057 PMCID: PMC10067738 DOI: 10.3389/fphar.2023.1057144] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2022] [Accepted: 02/23/2023] [Indexed: 03/22/2023] Open
Abstract
Ischemia-reperfusion injury (IRI) is an inevitable pathological process after organic transplantations. Although traditional treatments restore the blood supply of ischemic organs, the damage caused by IRI is always ignored. Therefore, the ideal and effective therapeutic strategy to mitigate IRI is warrented. Curcumin is a type of polyphenols, processing such properties as anti-oxidative stress, anti-inflammation and anti-apoptosis. However, although many researches have been confirmed that curcumin can exert great effects on the mitigation of IRI, there are still some controversies about its underlying mechanisms among these researches. Thus, this review is to summarize the protective role of curcumin against IRI as well as the controversies of current researches, so as to clarify its underlying mechanisms clearly and provide clinicians a novel idea of the therapy for IRI.
Collapse
Affiliation(s)
- Minglei Bi
- Department of Plastic Surgery, Lanzhou University Second Hospital, Lanzhou, Gansu, China
| | - Danyi Li
- Department of Ophthalmology, Jiading District Central Hospital, Shanghai University of Medicine and Health Sciences, Shanghai, China
| | - Jin Zhang
- Department of Plastic Surgery, Lanzhou University Second Hospital, Lanzhou, Gansu, China
- *Correspondence: Jin Zhang,
| |
Collapse
|
3
|
Berry AW, Monro S. Ageing in obscurity: a critical literature review regarding older intersex people. Sex Reprod Health Matters 2022; 30:2136027. [DOI: 10.1080/26410397.2022.2136027] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Affiliation(s)
- Adeline W. Berry
- Marie Curie Research Fellow, University of Huddersfield, Huddersfield, UK. Correspondence:
| | - Surya Monro
- Professor of Sociology and Social Policy, University of Huddersfield, Huddersfield, UK
| |
Collapse
|
4
|
Indications for Emergent Hyperbaric Oxygen Therapy. CURRENT EMERGENCY AND HOSPITAL MEDICINE REPORTS 2022. [DOI: 10.1007/s40138-022-00251-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/15/2022]
|
5
|
Chua ME, Kim JJK, Ming JM, De Jesus MJ, See MC, Bagli DJ, Rickard M, Koyle MA, Lorenzo AJ. The utilization of hyperbaric oxygenation therapy in hypospadias repair: a systematic review and meta-analysis. Int Urol Nephrol 2022; 54:273-285. [PMID: 35024997 DOI: 10.1007/s11255-021-03096-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2021] [Accepted: 12/12/2021] [Indexed: 10/19/2022]
Abstract
INTRODUCTION This study aimed to evaluate the efficacy and safety of Hyperbaric Oxygen Therapy (HBOT) use in hypospadias repair through systematic review and meta-analysis of comparative studies. METHODS A systematic literature search was performed in May 2021. Comparative studies assessing the surgical outcome of hypospadias repair between control versus HBOT utilization were identified and evaluated according to Cochrane collaboration recommendations. The assessed outcome includes hypospadias repair failures and graft failure for staged repair using a buccal graft. Relative risk with corresponding 95% confidence intervals (CI) were extrapolated. A random-effect model was used to generate pooled effect estimates. Heterogeneity and inter-study variability were assessed using Chi-square and I-square. Subgroup analysis was performed according to primary repair versus redo-hypospadias with buccal graft. PROSPERO registration (CRD42021251423). RESULTS Five comparative studies with 576 cases (301 HBOT versus 275 controls) were included. Overall pooled effect estimates showed that the HBOT group has significantly lesser hypospadias repair failure (RR 0.52, 95%CI 0.37, 0.72). Subgroup analysis on the use of HBOT for graft take showed lesser graft failure compared to the control group (RR 0.20, 95% CI 0.05, 0.75), while the use of HBOT for primary and redo single staged hypospadias repair showed lesser complication rate (RR 0.56, 95%CI 0.40, 0.78). Based on ROBINS-I assessment, all included comparative studies are determined to be of serious risk of bias mainly due to presence of confounding. CONCLUSION The currently available low-quality of evidence suggests that compared to control groups, HBOT as an adjunctive intervention to complicated hypospadias repair was able to reduce surgical outcome failure and graft failure rates.
Collapse
Affiliation(s)
- Michael E Chua
- Global Surgery, Department of Surgery, University of Toronto, Toronto, ON, Canada. .,Division of Urology, Hospital for Sick Children, Toronto, ON, Canada. .,Institute of Urology, St. Luke's Medical Center, NCR, Quezon City, Philippines.
| | | | - Jessica M Ming
- Department of Surgery, University of New Mexico, Albuquerque, NM, USA
| | - Mark Jason De Jesus
- Institute of Urology, St. Luke's Medical Center, NCR, Quezon City, Philippines
| | - Manuel C See
- Institute of Urology, St. Luke's Medical Center, NCR, Quezon City, Philippines
| | - Darius J Bagli
- Division of Urology, Hospital for Sick Children, Toronto, ON, Canada
| | - Mandy Rickard
- Division of Urology, Hospital for Sick Children, Toronto, ON, Canada
| | - Martin A Koyle
- Division of Urology, Hospital for Sick Children, Toronto, ON, Canada
| | - Armando J Lorenzo
- Division of Urology, Hospital for Sick Children, Toronto, ON, Canada
| |
Collapse
|
6
|
Oley MH, Oley MC, Iskandar AAA, Toreh C, Tulong MT, Faruk M. Hyperbaric Oxygen Therapy for Reconstructive Urology Wounds: A Case Series. Res Rep Urol 2021; 13:841-852. [PMID: 34984197 PMCID: PMC8709556 DOI: 10.2147/rru.s331161] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2021] [Accepted: 11/25/2021] [Indexed: 11/23/2022] Open
Abstract
INTRODUCTION Hyperbaric oxygen therapy (HBOT) has been applied to urological wound healing because it reduces inflammation, facilitates angiogenesis through endothelial proliferation, stimulates fibroblast, lymphocyte, and macrophage activity, and exerts bactericidal effects. Thus, we present a case series of reconstructive urology wounds treated adjunctively with HBOT. CASE REPORT Here, we present the cases of eight patients with urology wounds who underwent different forms of surgical reconstruction. Three patients received penile shaft silicone fluid injection with repeated infection, successful excision of a siliconoma mass, and defect closure with a full-thickness skin graft. One patient had hypospadias and multiple post-closure fistulae. Two patients had bilateral keystone flaps (post total penectomy, orchidectomy, perineotomy, and penile tumors) closed with a split-thickness skin graft (STSG). Two patients had Fournier's gangrene in their genital area, for which the wound was debrided and then closed with a STSG. All patients received HBOT after surgery with satisfying results. CONCLUSION HBOT promotes wound healing and improves graft integration in patients undergoing urological reconstructive surgery.
Collapse
Affiliation(s)
- Mendy Hatibie Oley
- Plastic Reconstructive and Aesthetic Surgery Division, Department of Surgery, Faculty of Medicine, Sam Ratulangi University, Manado, Indonesia
- Plastic Reconstructive and Aesthetic Surgery Division, Department of Surgery, R. D. Kandou Hospital, Manado, Indonesia
- Hyperbaric Centre Siloam Hospital, Manado, Indonesia
| | - Maximillian Christian Oley
- Hyperbaric Centre Siloam Hospital, Manado, Indonesia
- Division of Neurosurgery, Department of Surgery, Faculty of Medicine, Sam Ratulangi University, Manado, Indonesia
- Division of Neurosurgery, Department of Surgery, R. D. Kandou Hospital, Manado, Indonesia
| | - Ari Astram Adhiatma Iskandar
- Division of Urology, Department of Surgery, Faculty of Medicine, Sam Ratulangi University, Manado, Indonesia
- Division of Urology, Department of Surgery, R. D. Kandou Hospital, Manado, Indonesia
| | - Christof Toreh
- Division of Urology, Department of Surgery, Faculty of Medicine, Sam Ratulangi University, Manado, Indonesia
- Division of Urology, Department of Surgery, R. D. Kandou Hospital, Manado, Indonesia
| | | | - Muhammad Faruk
- Department of Surgery, Faculty of Medicine, Hasanuddin University, Makassar, Indonesia
| |
Collapse
|
7
|
El Hawa AAA, Bekeny JC, Phillips NW, Johnson-Arbor K. Hyperbaric oxygen therapy for paediatric patients: an unintended consequence of the COVID-19 pandemic. J Wound Care 2021; 30:S24-S28. [PMID: 34554855 DOI: 10.12968/jowc.2021.30.sup9.s24] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
OBJECTIVE Hyperbaric oxygen therapy (HBOT) is a useful adjunctive treatment for selected complicated wounds, including severe diabetic lower extremity ulcerations and compromised skin grafts or flaps. The Sars-CoV-2 (COVID-19) pandemic has disrupted healthcare delivery, with its effects extending to delivery of HBOT. During the pandemic, paediatric patients in our geographic region who were referred for HBOT faced challenges as centres temporarily closed or were unprepared to treat younger patients. Our monoplace HBOT centre modified existing practices to allow for treatment of these patients. This study aims to outline the steps necessary to adapting a pre-existing HBOT centre for the safe treatment of paediatric patients. METHOD A retrospective review was performed to identify patients 18 years of age or younger referred for HBOT during 2020. Patient characteristics, referral indications and HBOT complications were collected. Changes implemented to the HBOT centre to accommodate the treatment of paediatric patients were documented. RESULTS A total of seven paediatric patients were evaluated for HBOT and six were treated. The mean patient age was four years (range: 1-11 years). Referral diagnoses included sudden sensorineural hearing loss, skin flap or graft compromise, and radiation-induced soft tissue necrosis. All patients tolerated HBOT treatment in monoplace chambers without significant complications noted. Enhancements made to our clinical practice to facilitate the safe and effective treatment of paediatric patients included ensuring the availability of acceptable garments for paediatric patients, maintaining uninterrupted patient grounding (in relation to fire safety), and enhancing social support for anxiety reduction. CONCLUSION The results of our review show that paediatric patients can be safely treated within the monoplace hyperbaric environment.
Collapse
Affiliation(s)
- Areeg A Abu El Hawa
- Georgetown University School of Medicine, Washington, District of Columbia, US
| | - Jenna C Bekeny
- Georgetown University School of Medicine, Washington, District of Columbia, US
| | - Nituna W Phillips
- Center for Wound Healing and Hyperbaric Medicine, MedStar Georgetown University Hospital, Washington, District of Columbia, US
| | - Kelly Johnson-Arbor
- Georgetown University School of Medicine, Washington, District of Columbia, US.,Department of Plastic and Reconstructive Surgery, MedStar Georgetown University Hospital, Washington, District of Columbia, US
| |
Collapse
|