The effect of dexpanthenol/PRP impregnated biodegradable nanofiber application on healing in iatrogenically induced hypospadias surgery in rat model

INTRODUCTION: Hypospadias is a congenital malformation of the male urethra and penis, which is characterized by the opening of the urethra being located ventrally. The development of a fistula after hypospadias surgery requires good tissue healing in addition to surgical technique and experience. The use of biodegradable materials has been considered due to the possibility of causing tissue trauma during the removal of postoperative dressing materials. Dexpanthenol, a B-complex vitamin, increases mitotic activity and exhibits anti-inflammatory effects. Platelet-rich plasma (PRP) plays a role in hemostasis, fibrous connective tissue formation, and revascularization[1]. Biodegradable nanopolymer means nanomaterials that can be broken down by microorganisms. MATERIAL-METHOD: The study was a prospective randomized animal study conducted at the Necmettin Erbakan University KONÜDAM Experimental Medicine Application and Research Center. The study utilized 70 healthy male adult rats as experimental subjects. The subjects were distributed in a total of 7 groups. Each group consisted of 10 rats. Except for the 1st and 7th groups, iatrogenic hypospadias was created in all rats. Except for the 2 rats in the Sham group, all animals were sacrificed after penectomy according to the recommendations in the references. Penectomy was performed on 2 rats in Group 1 after intracardiac blood collection to obtain PRP. It was decided that the most suitable polymer for nanofiber production would be PLA. A portion of the PLA polymer was mixed with Dexpanthenol/PRP in various ratios. The nanofibers were separated from the aluminum foil and wrapped on the wound. After penectomy, sections were taken for histopathological examination, and Hematoxylin-Eosin and Masson Trichrome stains were applied. Fibrosis, inflammation, hyperemia, edema, suture reaction, and fistula were evaluated and scored by creating a scoring system. The data collected in this study were analysed using the SPSS software. RESULTS: All groups were examined pairwise, three by three, and collectively. After iatrogenic hypospadias was applied to the groups except for the Sham (Group 1) and only nanofiber-wrapped (Group 7) groups, the groups that were left to secondary healing (Group 2), only nanofiber-wrapped (Group 3), dexpanthenol-impregnated nanofiber-applied (Group 4), PRP-containing nanofiber-applied (Group 5), dexpanthenol and PRP-containing nanofiber-applied (Group 6) were compared. In the fibrosis scoring, significant differences were observed between Groups 2-4(sek-dexp), Groups 3-5(nano-prp), Groups 4-5(dexp-prp), and Groups 5-6( prp- dexp+prp) in terms of p-values. In the hyperemia scoring, A significant difference was reported in the p-values between Group 2-4(sek-dexp), Group 2-5(sek-prp), Group 2-6(sek-dexp+prp), Group 3-4(nano-dexp), Group 3-5(nano-prp), and Group 3-6(nano-dexp+prp). When the effect size was determined as d = 0.80, the error level as 5%, and the power value as 95%, the minimum number was calculated as 6 for each group in the power analysis. CONCLUSION: Biodegradable materials produced to reduce the postoperative complication rate in hypospadias surgery, contribute to urethral healing, and reduce psychological trauma have yielded successful results in rats. Dexpanthenol, which has positive effects on wound healing, can be easily impregnated and applied to scar tissue. More research is needed on PRP due to the difficulty in obtaining and applying it.