Oxidized Regenerated Cellulose (Fibrillar) Reduces Risk of Postoperative Corporal Bleeding Following Inflatable Penile Prosthesis Surgery

Alexander T. Rozanski, Boyd R. Viers, Alexander G. Liu, Nabeel A. Shakir, Travis J. Pagliara, Jeremy M. Scott, Mary L. West, Allen F. Morey

Research output: Contribution to journalArticle

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Abstract

Objective: To report our initial experience with oxidized regenerated cellulose (ORC; Surgicel Fibrillar) as a hemostatic adjunct during inflatable penile prosthesis (IPP) surgery. Materials and Methods: Beginning in April 2016, ORC pledgets were placed within the corporotomy closures of all men undergoing IPP insertion. Perioperative characteristics and outcomes including cumulative postoperative drain output were evaluated among consecutive cases with (April 2016 to October 2016) and without ORC (December 2015 to March 2016) using an identical surgical technique by a single surgeon. Results: During the study period, 64 men underwent IPP implantation, of whom 32 (50%) received ORC. There was a significant reduction in median drain output relative to controls (33 mL vs 65 mL; P = .01). Postoperatively, ORC use was associated with a reduction in the number of patient phone calls for scrotal-related concerns in the immediate postoperative period (average 0.5 vs 1.1; P = .03). There were 3 IPP explantations in the non-ORC group (2/3 for infection)-one of which was directly related to an infected hematoma. After controlling for other clinical features, the use of ORC (β -32, 95% confidence interval: -61 to -5; P = .02) was independently associated with a reduction in drain output. Conclusion: ORC use during IPP corporotomy closure reduces postoperative drain output, a known risk factor for hematoma-related complications.

Original languageEnglish (US)
JournalUrology
DOIs
StateAccepted/In press - 2017

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oxidized cellulose
Penile Prosthesis
Hemorrhage
Hematoma
Penile Implantation
Hemostatics
Postoperative Period
Confidence Intervals
Infection

ASJC Scopus subject areas

  • Urology

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Oxidized Regenerated Cellulose (Fibrillar) Reduces Risk of Postoperative Corporal Bleeding Following Inflatable Penile Prosthesis Surgery. / Rozanski, Alexander T.; Viers, Boyd R.; Liu, Alexander G.; Shakir, Nabeel A.; Pagliara, Travis J.; Scott, Jeremy M.; West, Mary L.; Morey, Allen F.

In: Urology, 2017.

Research output: Contribution to journalArticle

Rozanski, Alexander T. ; Viers, Boyd R. ; Liu, Alexander G. ; Shakir, Nabeel A. ; Pagliara, Travis J. ; Scott, Jeremy M. ; West, Mary L. ; Morey, Allen F. / Oxidized Regenerated Cellulose (Fibrillar) Reduces Risk of Postoperative Corporal Bleeding Following Inflatable Penile Prosthesis Surgery. In: Urology. 2017.
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abstract = "Objective: To report our initial experience with oxidized regenerated cellulose (ORC; Surgicel Fibrillar) as a hemostatic adjunct during inflatable penile prosthesis (IPP) surgery. Materials and Methods: Beginning in April 2016, ORC pledgets were placed within the corporotomy closures of all men undergoing IPP insertion. Perioperative characteristics and outcomes including cumulative postoperative drain output were evaluated among consecutive cases with (April 2016 to October 2016) and without ORC (December 2015 to March 2016) using an identical surgical technique by a single surgeon. Results: During the study period, 64 men underwent IPP implantation, of whom 32 (50{\%}) received ORC. There was a significant reduction in median drain output relative to controls (33 mL vs 65 mL; P = .01). Postoperatively, ORC use was associated with a reduction in the number of patient phone calls for scrotal-related concerns in the immediate postoperative period (average 0.5 vs 1.1; P = .03). There were 3 IPP explantations in the non-ORC group (2/3 for infection)-one of which was directly related to an infected hematoma. After controlling for other clinical features, the use of ORC (β -32, 95{\%} confidence interval: -61 to -5; P = .02) was independently associated with a reduction in drain output. Conclusion: ORC use during IPP corporotomy closure reduces postoperative drain output, a known risk factor for hematoma-related complications.",
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AU - Rozanski, Alexander T.

AU - Viers, Boyd R.

AU - Liu, Alexander G.

AU - Shakir, Nabeel A.

AU - Pagliara, Travis J.

AU - Scott, Jeremy M.

AU - West, Mary L.

AU - Morey, Allen F.

PY - 2017

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N2 - Objective: To report our initial experience with oxidized regenerated cellulose (ORC; Surgicel Fibrillar) as a hemostatic adjunct during inflatable penile prosthesis (IPP) surgery. Materials and Methods: Beginning in April 2016, ORC pledgets were placed within the corporotomy closures of all men undergoing IPP insertion. Perioperative characteristics and outcomes including cumulative postoperative drain output were evaluated among consecutive cases with (April 2016 to October 2016) and without ORC (December 2015 to March 2016) using an identical surgical technique by a single surgeon. Results: During the study period, 64 men underwent IPP implantation, of whom 32 (50%) received ORC. There was a significant reduction in median drain output relative to controls (33 mL vs 65 mL; P = .01). Postoperatively, ORC use was associated with a reduction in the number of patient phone calls for scrotal-related concerns in the immediate postoperative period (average 0.5 vs 1.1; P = .03). There were 3 IPP explantations in the non-ORC group (2/3 for infection)-one of which was directly related to an infected hematoma. After controlling for other clinical features, the use of ORC (β -32, 95% confidence interval: -61 to -5; P = .02) was independently associated with a reduction in drain output. Conclusion: ORC use during IPP corporotomy closure reduces postoperative drain output, a known risk factor for hematoma-related complications.

AB - Objective: To report our initial experience with oxidized regenerated cellulose (ORC; Surgicel Fibrillar) as a hemostatic adjunct during inflatable penile prosthesis (IPP) surgery. Materials and Methods: Beginning in April 2016, ORC pledgets were placed within the corporotomy closures of all men undergoing IPP insertion. Perioperative characteristics and outcomes including cumulative postoperative drain output were evaluated among consecutive cases with (April 2016 to October 2016) and without ORC (December 2015 to March 2016) using an identical surgical technique by a single surgeon. Results: During the study period, 64 men underwent IPP implantation, of whom 32 (50%) received ORC. There was a significant reduction in median drain output relative to controls (33 mL vs 65 mL; P = .01). Postoperatively, ORC use was associated with a reduction in the number of patient phone calls for scrotal-related concerns in the immediate postoperative period (average 0.5 vs 1.1; P = .03). There were 3 IPP explantations in the non-ORC group (2/3 for infection)-one of which was directly related to an infected hematoma. After controlling for other clinical features, the use of ORC (β -32, 95% confidence interval: -61 to -5; P = .02) was independently associated with a reduction in drain output. Conclusion: ORC use during IPP corporotomy closure reduces postoperative drain output, a known risk factor for hematoma-related complications.

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