Comparison of dressing removal following hypospadias repair

Hypospadias occurs when the urethral folds fail to fuse on the ventral aspect of the penis (Thomas and Barker, 1997). Surgical repair is often warranted and standard postoperative practice in the UK often includes the application of a dressing around the penis. This article reports the outcome of a small randomized controlled feasibility study to compare two methods of dressing removal following hypospadias repair. The same dressing was used throughout the study--a control group used a standard method of dressing removal, while an experimental group had an additional barrier film applied before the dressing was attached to the wound. The primary outcome measure was the time taken to remove the dressing. The time interval between starting the process of dressing removal and having no dressing left in place was used for statistical analysis. Secondary measures included assessment of the child's pain at different intervals by the parents and by an independent nurse observer. General discussion took place with the parents regarding any experience of anxiety. This was to assess whether parental anxiety should be measured in a future randomized controlled trial (RCT). There appeared to be implications with regard to time savings with the new method of dressing removal. Issues about the most suitable environment to remove dressing and differences between pain assessments of nurse and parent are noted. This was only a small-scale study. To investigate these issues more fully, a RCT has since been developed, has gained ethical approval and is due to start in August 2003.