Use of Contractubex® (Allantoin, Heparin, Extractum Cepae) to Prevent Scar Formation in The Rabbits to Which Primary Closure has been Applied After Urethrotomy

The scar tissue occurring in operating area after the repair of hypospadias which is one of the common congenital anomalies of male children has part in formation of post-operative complications. Many surgical techniques and materials have been used to reduce complications. The purpose of this study is to research the effects of contractubex ® (allantoin, heparin, extractum cepae [AHEC]) gel on development of scar in the area repaired after urethrotomy. In the study, 45 male White New Zealand rabbits were used. The rabbits were divided into three groups randomly. Group 1(K): The group to which urethrotomy and primary closure were applied Group 2(A): The group to which urethrotomy, primary closure + 15-day AHEC were applied Group 3(B): The group to which urethrotomy, primary closure + 30-day AHEC were applied Urethras of the rabbits in the groups were calibrated with angiocath (24 Fr) once a day for 30 days. Along with calibration, AHEC was applied to the urethras of the rabbits in 2 nd group for 15 days and urethras of the rabbits in the 3rd group for 30 days. To evaluate scar tissue, macroscopic and histopathological evaluations were carried out. Although inflammation was much more in the groups to which AHEC was applied, fibrosis was determine d to be less. It is thought that the application of AHEC may be effective in reducing scar formation after operation.

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2. Price R, Lambe G, Jones R. Two-stage hypospadias repair: audit in a district general hospital. British journal of plastic surgery 2003; 56: 752-758.

3. Baskin LS, Ebbers MB. Hypospadias: anatomy, etiology, and technique. Journal of pediatric surgery 2006; 41: 463-472.

4. Wilcox D, Snodgrass W. Long-term outcome following hypospadias repair. World journal of urology 2006; 24: 240-243.

5. Alexander K, Leung WL. Robson. Hypospadias: an update. Asian J Androl 2007; 9: 16-22.

6. Gallentine ML, Morey AF, Thompson IM, Jr. Hypospadias: a contemporary epidemiologic assessment. Urology 2001; 57: 788-790.

7. Silver RI, Rodriguez R, Chang TS, Gearhart JP. In vitro fertilization is associated with an increased risk of hypospadias. J Urol 1999; 161: 1954-1957.

8. Dolk H. Epidemiology of Hypospadias. In: Hadidi AT, Azmy AF (eds). Hypospadias Surgery. 1st edition. Berlin: Springer; Vol 1st edition. Berlin: Springer 2004; 51-57.

9. Snyder CL, Evangelidis A, Hansen G, et al. Management of complications after hypospadias repair. Urology 2005; 65: 782-785.

10. Nuininga JE, RP DEG, Verschuren R, Feitz WF. Long-term outcome of different types of 1-stage hypospadias repair. J Urol 2005; 174: 1544-1548.

11. Sunay M, Dadalı M, Karabulut A, Emir L, Erol D. Our 23-year experience in urethrocutaneous fistulas developing after hypospadias surgery. Urology 2007; 69: 366-368.

12. Draelos ZD. The ability of onion extract gel to improve the cosmetic appearance of postsurgical scars. Journal of cosmetic dermatology 2008; 7: 101-104.

13. Stozkowska W, Raczyńska K. Efficiency and application safety of Cepan cream. Observation of a new indication. Przeglad lekarski. 2008; 65: 241- 243.

14. Arikan S, Adas G, Barut G, et al. An evaluation of low molecular weight heparin and hyperbaric oxygen treatment in the prevention of intraabdominal adhesions and wound healing. The American journal of surgery 2005; 189: 155-160.

15. Saliba Jr MJ. Heparin in the treatment of burns: a review. Burns 2001; 27: 349-358.

16. Majewski S, Chadzynska M. Effects of heparin, allantoin and cepae extract on the proliferation of keloid fibroblasts and other cells in vitro. Posterpräsentatio MS 1988; 24-29.

17. Wiesmann P. Effect fo Contractubex, an antikeloid medication, and its individual components on the synthesis and secretion of glycosaminoglycan, sulfated glycosaminoglycans and collagen in cultured skin fibroblasts. Merz Forschungsbericht. 1991.

18. Janicki S, Sznitowska M. Effect of ointments for treating scars and keloids on metabolism of collagen in scar and healthy skin. European journal of pharmaceutics and biopharmaceutics 1991; 37: 188-191.

19. Beuth J, Hunzelmann N, Van Leendert R, Basten R, Noehle M, Schneider B. Safety and efficacy of local administration of Contractubex® to hypertrophic scars in comparison to corticosteroid treatment. Results of a multicenter, comparative epidemiological cohort study in Germany. In vivo 2006; 20: 277-283.

20. Janicki S, Sznitowska M, Maceluch J, Jaśkowski J. Studies on the viscous-elastic properties of the skin in evaluating ointments to improve the elasticity of scars. Przeglad dermatologiczny 1988; 75: 352-357.

21. Koliadenko V, Stepanenko V, Bardov P. New approaches to the treatment and prophylaxis of the cicatrix formation. Klinichna khirurhiia 2001: 24-27.

22. Ayyildiz A, Çelebi B, Akgül KT, Nuhoğlu B, Caydere M, Germiyanoğlu C. A comparison of free skin graft, fascia lata, alloderm, bovine pericardium and primary repair in urethrocutaneous fistulas without diversion: an experimental study. Pediatric surgery international 2006; 22: 809-814.

23. Gill NA, Hameed A. Management of hypospadias cripples with two-staged Bracka's technique. J Plast Reconstr Aesthet Surg 2011; 64: 91-96.

24. Ozay R, Yavuz OY, Aktas A, et al. Effects of cepae extract, allantoin, and heparin mixture on developing andalready formed epidural fibrosis in a rat laminectomy model. Turk J Med Sci 2016; 46: 1233-1239.

25. Dorsch W, Schneider E, Bayer T, Breu W, Wagner H. Anti-inflammatory effects of onions: inhibition of chemotaxis of human polymorphonuclear leukocytes by thiosulfinates and cepaenes. Int Arch Allergy Appl Immunol 1990; 92: 39-42.

26. Levine E, Cupp AS, Miyashiro L, Skinner MK. Role of transforming growth factor-alpha and the epidermal growth factor receptor in embryonic rat testis development. Biol Reprod 2000; 62: 477- 490.

27. Sarhan OM, El-Hefnawy AS, Hafez AT, Elsherbiny MT, Dawaba ME, Ghali AM. Factors affecting outcome of tubularized incised plate (TIP) urethroplasty: single-center experience with 500 cases. J Pediatr Urol 2009; 5: 378-382.

28. Mohamed S, Mohamed N, Esmael T, Khaled S. A simple procedure for management of urethrocutaneous fistulas; post-hypospadias repair. Afr J Paediatr Surg 2010; 7: 124-128.

29. Diner EK, Patel SV, Kwart AM. Does fibrin sealant decrease immediate urinary leakage following radical retropubic prostatectomy? J Urol 2005; 173: 1147-1149.

30. Gopal SC, Gangopadhyay AN, Mohan TV, et al. Use of fibrin glue in preventing urethrocutaneous fistula after hypospadias repair. J Pediatr Surg 2008; 43: 1869-1872.

31. Gargollo PC, Cai AW, Borer JG, Retik AB. Management of recurrent urethral strictures after hypospadias repair: is there a role for repeat dilation or endoscopic incision? J Pediatr Urol 2011; 7: 34-38.

32. Tredget EE, Anzarut A. Effect of Mederma on hypertrophic scarring in the rabbit ear model by Alexandrina S. Saulis, MD, Jon H. Mogford, Ph.D., and Thomas A. Mustoe, MD - Discussion. Plast Reconstr Surg 2002; 110: 184-186.

33. Ho WS, Ying SY, Chan PC, Chan HH. Use of onion extract, heparin, allantoin gel in prevention of scarring in chinese patients having laser removal of tattoos: A prospective randomized controlled trial. Dermatol Surg 2006; 32: 891-896.

34. Willital GH, Heine H. Efficacy of Contractubex(R) Gel in the Treatment of Fresh Scars after Thoracic-Surgery in Children and Adolescents. International Journal of Clinical Pharmacology Research 1994; 14: 193-202.

35. Beuth J, Hunzelmann N, Van Leendert R, Basten R, Noehle M, Schneider B. Safety and efficacy of local administration of Contractubex (R) to hypertrophic scars in comparison to corticosteroid treatment. Results of a multicenter, comparative epidemiological cohort study in Germany. In Vivo 2006; 20: 277-283.

36. Willital G, Heine H. Efficacy of Contractubex gel in the treatment of fresh scars after thoracic surgery in children and adolescents. International journal of clinical pharmacology research 1994; 14: 193-202.

37. Prager W, Gauglitz GG. Effectiveness and Safety of an Overnight Patch Containing Allium cepa Extract and Allantoin for Post-Dermatologic Surgery Scars. Aesthet Plast Surg 2018; 42: 1144- 1150.
Eastern Journal of Medicine-Cover
  • ISSN: 1301-0883
  • Başlangıç: 1996
  • Yayıncı: ERBİL KARAMAN
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