Authors (including presenting author) :
Wong PY(1), Tse YB(1), Ng SL(1), Chun TTS(2), Ng TL(1)
Affiliation :
(1)Department of Surgery, Queen Mary Hospital, (2)Department of Surgery, The University of Hong Kong
Introduction :
Hypergranulation around the Suprapubic catheters (SPCs) site is a common issue for patients with long-term catheters, which could cause bleeding and pain during catheter change and might required caustic agents, such as silver nitrate, and would potentially result in surrounding skin damage and necrosis.
In Hong Kong, SPC dressing (with a gauze covered) has been adopted as a standard care for many year. Current clinical guidelines from the European Association of Urology Nurses (EAUN) and the Continence Nurses Society Australia recommend avoiding dressings over healed SPC site to reduce hypergranulation. The guidelines were implemented in Urology Nurse Clinic at Queen Mary Hospital in 2022 for patients suffering with hypergranulation from SPC.
In Hong Kong, there is limited clinical data on the effect of “no dressing” in reducing hypergranulation around SPC site. This study aims to retrospectively observe and evaluate the impact of avoiding dressings on the development of granulomas in patients with long-term SPC.
Objectives :
The study aims to retrospectively evaluate the impact of avoiding dressings on the existing granulomas in patients with long-term SPC. The primary outcome is the percentage of patients with improvement or resolution of granulomas after adopting the no-dressing method. Secondary outcomes include time required for resolution or improvement, and other adverse events or care difficulties encountered adopting the new method.
Methodology :
A retrospective observational study was conducted using the Pre-Post method, involving patients with long-term SPC under the care of the Urology Nurse Clinic at Queen Mary Hospital during 1st January 2022 to 31st December 2024 were screened and only those have adopted the no dressing method was included in the analysis. Clinical data related to SPC care and related adverse events before and after applying the new method were retrieved captured from the Clinical Management System for the period of 1st January 2022 to 31st December 2024..
Result & Outcome :
In this preliminary study, 15 patients with long-term SPC were identified. From 2022 to 2024, 70% of patients presented with granulomas around SPC tract for an average 3 months prior to avoiding dressings. Overall, 85% of patients reported improvements in hypergranulation after adopting the no dressing practice, with almost 90% resulted in a reduction in granuloma size and 72% complete healing respectively. There was no identified side effects or infections caused by the no-dressing in this study.
