Comparitive Study between Autologous Platelet-Rich Fibrin Membrane as A Second Layer Versus Dartos Flap in Complicated Hypospadias Cases in Pediatrics
Youssif, R., Arafa, M., ELshimy, K., Nosair, N., Ismail, K., Mahmoud, S. (2025). Comparitive Study between Autologous Platelet-Rich Fibrin Membrane as A Second Layer Versus Dartos Flap in Complicated Hypospadias Cases in Pediatrics. EKB Journal Management System, 44(3), 1016-1022. doi: 10.21608/ejsur.2025.354305.1361
Ragab Saeid Youssif; Mohamed Ahmed Arafa; Khalid Ahmed ELshimy; Nahla Abd El- Azeez Nosair; Khalid Ahmed Ismail; Sherif Medhat Mahmoud. "Comparitive Study between Autologous Platelet-Rich Fibrin Membrane as A Second Layer Versus Dartos Flap in Complicated Hypospadias Cases in Pediatrics". EKB Journal Management System, 44, 3, 2025, 1016-1022. doi: 10.21608/ejsur.2025.354305.1361
Youssif, R., Arafa, M., ELshimy, K., Nosair, N., Ismail, K., Mahmoud, S. (2025). 'Comparitive Study between Autologous Platelet-Rich Fibrin Membrane as A Second Layer Versus Dartos Flap in Complicated Hypospadias Cases in Pediatrics', EKB Journal Management System, 44(3), pp. 1016-1022. doi: 10.21608/ejsur.2025.354305.1361
Youssif, R., Arafa, M., ELshimy, K., Nosair, N., Ismail, K., Mahmoud, S. Comparitive Study between Autologous Platelet-Rich Fibrin Membrane as A Second Layer Versus Dartos Flap in Complicated Hypospadias Cases in Pediatrics. EKB Journal Management System, 2025; 44(3): 1016-1022. doi: 10.21608/ejsur.2025.354305.1361

Comparitive Study between Autologous Platelet-Rich Fibrin Membrane as A Second Layer Versus Dartos Flap in Complicated Hypospadias Cases in Pediatrics

The Egyptian Journal of Surgery
Article 28, Volume 44, Issue 3, July 2025, Pages 1016-1022    PDF (491.24 K)
Document Type: Original Article
DOI: 10.21608/ejsur.2025.354305.1361
Authors
Ragab Saeid Youssif* 1; Mohamed Ahmed Arafa2; Khalid Ahmed ELshimy2; Nahla Abd El- Azeez Nosair3; Khalid Ahmed Ismail1; Sherif Medhat Mahmoud1
1Departments of General Pediatric Surgery, Faculty of Medicine, Kafr Elsheikh University, KafrElsheikh, Egypt
2Departments of Pediatric Surgery, Faculty of Medicine, Tanta University, Tanta, Egypt
3Department of Clinical Pathology, Faculty of Medicine, Kafr Elsheikh University, KafrElsheikh, Egypt
Abstract
Background: Hypospadias, a common congenital anomaly, requires surgical intervention to enhance functional and
aesthetic outcomes. Despite advancements, postoperative complications such as urethra-cutaneous fistula (UCF) and
glans dehiscence remain prevalent.
Objectives: This study compares its results with those of the conventional Dartos flap technique to assess the effectiveness of platelet-rich fibrin (PRF) membrane as a second layer covering in the healing of complicated hypospadias in pediatric male patients.
Patients and methods: A total of 56 male patients, ranging in age from 6 months to 16 years old, were recruited and
equally divided into two groups for a randomized controlled trial. Group A had a traditional Dartos flap covering, whereas group B used a PRF membrane.
Results: Median age was 5.25 years (group A) and 3.17 years (group B). Group B showed significantly faster edema
resolution (3 vs. 4 days, P= 0.029) and reduced UCF incidence (3.6 vs. 21.4%, P= 0.043) and infection rates (3.6 vs.
28.6%, P= 0.024). Operative time was shorter in group B (93.64 vs. 99.86min, P= 0.037).
Conclusion: PRF membrane significantly enhances surgical outcomes in hypospadias repair by reducing the occurrence
of UCF and infection while minimizing operative time. PRF offers a promising alternative to conventional techniques,
particularly in complicated cases.
Keywords
Dartos flap; Hypospadias; Pediatric surgery; Platelet-rich fibrin; Urethro-cutaneous fistula
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