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Postoperative aesthetic and healing features of postectomy using three different surgical techniques: a randomized,
Bruno Pinheiro FalcÃo1, Marcelo Marcondes Stegani1,2, SÉrgio Bernardo TenÓrio2,3
1- Universidade Federal do Paraná, Departamento de Cirurgia Pediátrica - Curitiba - PR - Brasil.
Insights
Different circumcision techniques yield varied healing and aesthetic outcomes in children. The Plastibell® device excelled in healing, while subcuticular stitches offered superior aesthetics, though expert opinions differed.
Area of Science:
- Pediatric Surgery
- Dermatology
- Plastic Surgery
Background:
- Postectomy, or circumcision, is a common procedure in children.
- Evaluating postoperative esthetic and healing outcomes is crucial for patient and parental satisfaction.
Purpose of the Study:
- To compare the postoperative esthetic and healing results of postectomy performed using three different surgical techniques.
- To assess the impact of expert evaluations from dermatology, pediatrics, and plastic surgery on perceived outcomes.
Main Methods:
- A prospective, randomized clinical trial involving 149 preschool children indicated for circumcision.
- Comparison of three techniques: Plastibell® device (PB), conventional (CV), and conventional with subcuticular stitches (SC).
- Postoperative esthetic and healing features were scored by three specialists at 30 and 60 days.
Main Results:
- Most patients achieved excellent healing (70%) and esthetic (56%) results.
- The PB group showed the best healing outcomes (p=0.028), while the SC group demonstrated superior esthetics (p=0.002).
- Expert assessments varied, with no significant differences in complications across groups.
Conclusions:
- Surgical techniques for pediatric postectomy are perceived differently regarding healing and esthetics by various medical specialists.
- Expert opinions on esthetic and healing parameters diverged, indicating a subjective element in outcome assessment.
- The choice of technique may influence specific outcomes, necessitating consideration of both healing and esthetic goals.
Objective:
to compare the postoperative esthetic and healing aspects of postectomy performed by different surgical techniques, based on the evaluation of different specialty expert professionals.
Methods:
prospective and randomized clinical trial enrolling 149 preschool children with a medical indication for circumcision, divided into three groups: postectomy with the hemostatic device Plastibell® (PB group), conventional technique (CV group) and conventional with subcuticular stitches (SC group). Pictures were taken from patients at pre-defined angles on the 30th and 60th postoperative days. Photos were evaluated by three specialists (dermatologist, pediatrician and plastic surgeon), who assigned scores from 1 to 5 regarding the esthetic and healing features at each moment. Grades 4 or 5 from all specialists characterized "best result". Data were analysed to compare the used surgical techniques, the judgments from specialties and postoperative complications.
Results:
most of the patients obtained the "best result" regarding healing (70%) and esthetics (56%). The final overall result showed the PB group as the best for healing (p=0.028) and the SC group as the best for esthetics (p=0.002). For the dermatologist, on the 60th postoperative day, the CV group presented the worst aesthetic result, whereas for the pediatrician and the plastic surgeon, the PB group presented the best healing result and the SC group had the best esthetic result. There was no difference between the groups regarding the presence of complications.
Conclusion:
the most common surgical techniques used to perform postectomy in children were differently assessed regarding healing and esthetic features by distinct medical professionals. The analysis of these two parameters among experts from related areas diverged among them and over time.
