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.
This research aims to modify the components of stainless steel alloy by the method of surface engineering through the single diffusion coating technique in order to obtain new alloys with high efficiency in resisting harsh environmental conditions. Steam a mixture of sodium chloride ( ) and sodium sulfate ( ) at a temperature of 900 and then compare it with the base alloy. The results showed that the alloys produced in this way are very efficient. The results showed that the aluminum coating showed high efficiency in resisting oxidation and provided better protection for a longer time compared to the uncoated alloy due to the oxide crust layer formed with high adhesion as well as the aluminum-rich phases, whether the phase
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... Show MoreThe subject of youth care of important issues in view of what constitutes the importance
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are good psychological health and agree psychosocial be healthy to be effective to invest their
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aspects and economic. The universities of the most important educational institutions that
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different activities that will satisfy their needs physical, psychological, social and
The study of sex Structure and age characteristics of an important element of the
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the demographic, social and economic characteristics, particularly since each population
group varying characteristics in terms of age, sex entail social, demographic, cultural and
economic implications, and from that the researcher has taken from Structure of sex and age
for population in the district of Tuz Khurmatu for (1997-2012 ) the subject of consideration
and maintain compared to see the contrast between them. Qualitative Research for installation
and the age of the urban and rural areas has touched the judiciary, as well as its respects
Engineering equipment is essential part in the construction project and usually manufactured with long lead times, large costs and special engineering requirements. Construction manager targets that equipment to be delivered in the site need date with the right quantity, appropriate cost and required quality, and this entails an efficient supplier can satisfy these targets. Selection of engineering equipment supplier is a crucial managerial process .it requires evaluation of multiple suppliers according to multiple criteria. This process is usually performed manually and based on just limited evaluation criteria, so better alternatives may be neglected. Three stages of survey comprised number of public a
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