Chanjiv Singh

Abstract

A Chronic non-healing wound is one which has fails to progress through a timely sequence of repair or one that proceeds through the wound healing process without restoring anatomic and functional results. A wide variety of factors is thought to contribute to this problem. Concentrated Growth Factors (CGF) (first developed by Sacco (2006)) is a relatively new technology within the area of regenerative medicine. CGF is an advanced second generation platelet concentrate, obtained with differential continuous centrifugal technology. Use of CGF in management of chronic skin wounds has led to high rates of recovery but further works are required in order to improve the effectiveness of treatment protocols and the comfort and safety of patients. Its application is progressively spreading in the clinical field. Keywords: CGF, Quantitative data, HaCaT

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Abstract

Introduction: Surgery for Hypospadius is fraught with complications. The very fact that there are more than a hundred techniques described for this problem is evidence enough to confirm that no single technique is the perfect answer to our efforts. Aims and Objectives: The presenting author is a student of Dr.H.S.Asopa and an advocate of the perpucial island flap technique, though not dogmatic in its propagation. He has also had the opportunity to train with Mr. Aviar Bracka and uses different techniques judiciously. This presentation is about the details no author stresses upon for Hypospadius and surgery. Pre and post operative pictures are not the only teaching aids. Discussion: Ten Commandments for Hypospadius surgeons. These are in themselves self explanatory for the students of Hypospadius as well as the senior specialist. Results: We have been achieving consistant results even though we have not struck to any one technique. We have been using the modified Asopa-I technique (for almost half the cases) and Bracka technique as the two main methods for surgery. This step by step on pitfalls in hypospadius surgery is not to highlight surgical techniques but to discuss about steps which have their own importance to produce acceptable results. Conclusion: In spite of so many methods to perform surgery for patients of hypospadius, some general principles on tissue handling, suture management, prevention of edema, general method of dissection, dressing techniques etc go a long way in giving consistant results whatever the method used for the repair. Keywords: Hypospadius, Tissue handling, Infilteration, Fistula, perpucial Flap, Staged repair

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