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Hemostasis during hypospadias surgery via topical application of feracrylum citrate: A randomized prospective study
Brijesh K Lahoti1, Gaurav Aggarwal, Arvind Diwaker
1Department of Surgery, M.G.M Medical College & M.Y.H Group of Hospitals, Indore, Madhya Pradesh - 452 001, India.
Insights
Topical feracrylum citrate effectively reduced bleeding and complications in pediatric hypospadiac surgery. This hemostatic agent minimized cauterizations, blood loss, and postoperative issues in young patients.
Area of Science:
- Urology
- Pediatric Surgery
- Hemostasis
Background:
- Hypospadias repair in pediatric patients can involve significant hemorrhage-related complications.
- Minimizing intraoperative bleeding and postoperative swelling is crucial for successful surgical outcomes.
Purpose of the Study:
- To evaluate the efficacy of topical feracrylum citrate in reducing hemorrhage-related complications during pediatric hypospadias surgery.
- To compare outcomes between patients treated with feracrylum citrate and a control group receiving normal saline.
Main Methods:
- A randomized controlled trial involving 150 pediatric hypospadiac patients (75 in study, 75 in control).
- The study group received 1% feracrylum citrate solution topically, while the control group received normal saline.
- Assessed parameters included cauterization frequency, intraoperative blood loss, wound edema, and postoperative complications.
Main Results:
- The feracrylum citrate group required significantly fewer cauterizations (1.55 vs. 5.7 per patient) and had less intraoperative blood loss (17.8 ml vs. 31 ml).
- Postoperative hematoma (8% vs. 18%) and wound edema (13.3% vs. 47%) were notably lower in the feracrylum citrate group.
- Overall postoperative complications were reduced in patients treated with feracrylum citrate.
Conclusions:
- Topical feracrylum citrate is a safe and effective hemostatic agent for managing diffuse capillary oozing and surface bleeding in pediatric hypospadias surgery.
- Its use significantly decreases the need for cauterization, reduces tissue damage, and lowers the incidence of postoperative complications.
- Feracrylum citrate offers a valuable adjunct for improving surgical outcomes in pediatric hypospadias repair.
Aim:
Report of our experience with topical feracrylum citrate to minimize hemorrhage-related complications in pediatric hypospadiac patients.
Materials And Methods:
One hundred and fifty consecutive pediatric hypospadiac patients over 3 years (75 in study group and 75 controls - random allocation) were studied. One hundred milliliter of 1% feracrylum citrate solution was used in study cases and equivalent normal saline in controls. The parameters assessed were frequency of cauterizations, intraoperative blood loss, wound edema and postoperative complications.
Results:
Average number of cauterizations was 1.55 per patient in study group and 5.7 per patient among controls. Among cases, average number of blood soaked gauge pieces was 3.56 per patient, correlating with average intraoperative blood loss of 17.8 ml. In controls, average blood soaked gauge pieces were 6.2 per patient corresponding to an average blood loss of 31 ml. Postoperative hematoma was seen in 8% cases compared with 18% controls. Wound edema appeared in 13.3% cases and 47% controls. Postoperative complications were higher among controls.
Conclusions:
Feracrylum is an effective and safe topical hemostatic agent to minimize significantly diffuse capillary oozing and surface bleeding. It reduced the frequency of cauterization and tissue damage, intraoperative blood loss, postoperative hematoma, wound edema and postoperative complications.
