Available online on www.ijtpr.com International Journal of Toxicological and Pharmacological Research 2017; 9(3); 189-193 ISSN: 0975-5160 Research Article *Author for Correspondence: fahaduob@gmail.com Does the Choice of Suture Material Affect the Incidence of Urethrocutaneous Fistulae After Hypospadias Repair? – A Comparison of Polyglactin 910 with Polydioxanone Adnan Khalid 1 , Syed Hashim Zaidi 2 , Marvi Baloch 3 Fahad Saleem 4* 1 Consultant General & Paediatric Surgeon, Combined Military Hospital, Quetta, Pakistan 2 Consultant Paediatric Surgeon, Combined Military Hospital, Multan, Pakistan 3 Department of Pharmacolgy, Faculty of Pharmacy & Health Sciences, University of Balochistan, Quetta 4 Department of Pharmacy Practice, Faculty of Pharmacy & Health Sciences, University of Balochistan, Quetta Available Online:25 th July, 2017 ABSTRACT Background: We aimed to assess the incidence of developing postoperative urethrocutaneous fistulae (UCF) while using either polyglactin 910 or polydioxanone for the repair of subcoronal hypospadias in paediatric patients. Methods: A multicenter, two-group posttest-only randomized experimental design was adopted for the study. The study was conducted at PNS Shifa Hospital Karachi, Combined Military Hospital Malir, Military Hospital Rawalpindi and Combined Military Hospital Multan from 2009 to 2016. Boys between the ages of 1 – 10 years with confirmed diagnosis of subcoronal hypospadias suitable for single stage repair with the Snodgrass technique and also completing a minimum follow up of 6 months were targeted for the study. The subjects were later randomized into PG group (those undergoing urethral repair with polyglactin 901) and PD group (those in whom polydioxanone was used). Both descriptive and inferential statistics were used for data analysis. SPSS v. 21.0 was used for data analysis with p < 0.05 taken as significant value. Results: Two hundred patients with confirmed diagnosis of subcoronal hypospadias were recruited for the study in the proposed study period. Twenty-nine patients (29%) in the PG and 26 (26%) in the PD group developed UCF. There were seven (7%) cases of wound infection in the PG group compared to four cases (4%) in the PD Group; all eleven of the said were among those who developed UCF. Meatal stenosis was observed in six patients (6%) in the PG group and in nine patients (9%) of the PD group. No significant difference in the incidence of postoperative urethral fistula formation with the use of polyglactin 910 versus polydioxanone was however reported by the study findings. Conclusion: As there was no significant difference in the incidence UCF between Polyglactin 910 and Polydioxanone, the choice of suture material should be based on economical variations and availability of the two products. Keywords: Hypospadias, Polyglactin 910, Polydioxanone, Urethrocutaneous Fistula. INTRODUCTION Hypospadias is a common congenital anomaly affecting about 0.7% of newborn worldwide 1,2 . The fact that over 300 methods have been tried over the course of history for the repair of this anomaly, only serves to prove that search for the ideal method of repair is still being carried out 2 . For the past few decades, the most popular procedures have been the tubularized incised plate urethroplasty (Snodgrass technique) mainly employed for distal hypospadias and the 2-stage Bracka repair used for the proximal varieties 3,4 . Within this context, Urethrocutaneous fistula (UCF) continues to be a common and frustrating complication after hypospadias repair 5 . Reported incidence of fistula formation varies greatly from 0.48% to 44% 6,7 . However, in general practice, it is our personal observation that the incidence is more towards the higher side. Many factors are thought to contribute to fistula formation and amongst the various guidelines pertaining to the repair technique there is consensus regarding the gentle tissue handling, precise hemostasis, use of magnification and meticulous subcuticular suturing without any tension 8 . There are, however, many controversies too, such as the use of stents, types of dressings and which suture material to use. We aimed to address the last question in this study and focused on the two most commonly used suture materials used worldwide, polyglactin 910 and polydioxanone. There are numerous studies about suture material and how they behave in living tissue or on exposure to human urine 9,10 . Some have compared different sutures used with different techniques 11 . We, however, did not find any study which compared different sutures whilst keeping all other variables, such as age, location of hypospadic meatus, surgical technique, type of stents and dressing, almost identical in the two study groups. Therefore, we decided to compare two commonly employed absorbable suture materials (polyglactin 910 and polydioxanone), the former being multifilament and the latter monofilament.