Objective: to evaluate the benefit of coverage of
the urethral repair by dorsal dartos flap as a second
layer for preventing fistula and V like incision on
the tip of the glans for preventing meatal stenosis.
Patients and Methods:
Forty five children included in this study age
ranged ( 11 months – 7 years), they underwent
hypospadias repair between December 2008 to
March 2012, all cases with distal hypospadias,
same technique used for all patients, a combination
of techniques used for reconstruction starting
withtubularized incised plate urethroplasty with deepithelialized
or stripping of the skin from both
sides of U shaped incision surrounding the urethral
plate, adding a V like incision on the top (tip of
glans) of the midline urethral plate incision that
give wide meatus subsequently prevent meatal
stenosis and no need for dilatation after stent
removal, followed by harvesting well vascularized
dartos flap from de-epithelialized preputial skin
and transposing itventrally by buttonholing
maneuver and suturing the flap as a second layer
along the neourthral suture line, finally
approximation of glans , so achieving three layer
closure.
Results :All patients are followed for (6 months-
24 months) mean was 15 months, only two patients
(4.4%) complicated with small fistula at the
subcoronal region at the beginning of the study
operated after 6 months and the fistula closed
successfully. Twenty five cases (55.5%) with
Chordee were completely released with no
recurrence. No dilatation was needed after removal
of stent for neomeatus developed a good stream of
urine with no problems regarding stenosis.
Conclusions: In this study hypospadias repair
should achieve three layer closures by using a
dartosfalp as a second layer to cover neourethral
suture line combined with stripping the skin on the
edge of the U shaped incision to gain secure
closure of the neourethra, which will prevent
fistula formation. We recommend adding a
Vincision on the tip of the glans connected with
midline urethral plate incision to prevent meatal
stenosis.
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Find interested in the harmonization of variables and determinants of supply chain planning needs of the material, leading to the results start effective supply chain management, and end up quickly modify the sizes to suit the demand and turnover in the market. As well as identifying relationships between variables, and type of relationship used by the company with the processors and their feasibility, and indicate the level of interest and willingness to redesign the supply chain Company for Electrical Industries and build an integrated model for supply chain with the MRP system can be applied in the company.
Research depend on quantitative and descriptive method, It
... Show MoreThe present work aims to validate the experimental results of a new test rig built from scratch to evaluate the thermal behavior of the brake system with the numerical results of the transient thermal problem. The work was divided into two parts; in the first part, a three-dimensional finite-element solution of the transient thermal problem using a new developed 3D model of the brake system for the selected vehicle is SAIPA 131, while in the second part, the experimental test rig was built to achieve the necessary tests to find the temperature distribution during the braking process of the brake system. We obtained high agreement between the results of the new test rig with the numerical results based on the developed model of the brake
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