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Eur J Pediatr Surg 2023; 33(06): 441-453
DOI: 10.1055/a-2048-7486
Review Article

The Role of Postoperative Dressing in Hypospadias Surgery: A Systematic Review and Meta-analysis of the Pediatric Literature

Maria Escolino
1   Department of Pediatric Surgery, Federico II University Hospital, Napoli, Campania, Italy
,
Luisa Florio
1   Department of Pediatric Surgery, Federico II University Hospital, Napoli, Campania, Italy
,
Giovanni Esposito
2   Department of Biotechnologies, CEINGE Advanced Biotechnologies, Napoli, Campania, Italy
,
Ciro Esposito
1   Department of Pediatric Surgery, Federico II University Hospital, Napoli, Campania, Italy
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Abstract

This study aimed to describe the available dressings and their management in patients undergoing hypospadias repair and compare postoperative outcomes with and without dressing and between the different dressing types. A comprehensive electronic literature search of PubMed, Embase, and Cochrane Library was conducted to obtain studies, published in the period 1990 to 2021, reporting on the dressing used following hypospadias surgery. All information regarding the dressing was considered as primary endpoints, whereas surgical outcomes were assessed as secondary outcomes. Thirty-one studies containing 1,790 subjects undergoing hypospadias repair were included. Dressings were divided into three categories: nonadherent to the wound, adherent to the wound, and glue-based dressings. Most authors preferred to remove/change the dressing in the ward and the median time of removal/change was 6.56 postoperative days. The dressing removal appeared as the most frequent factor generating parental anxiety. The median rate of wound-related complications was 8.18%, of urethroplasty complications 9.08% and of reoperations 8.18%. Meta-analysis of outcomes showed higher risk of reoperations using conventional dressing, with no differences in urethroplasty and wound-related complications rates between conventional and glue-based dressings. Furthermore, the use of dressing reported increased risk of wound-related complications compared with no dressing, without significant differences regarding occurrence of urethroplasty complications and reoperations. The current evidence confirmed that there is no difference in outcomes of hypospadias repair depending on a certain dressing type. To date, surgeon's preference remains the main factor determining the choice for a specific dressing or for no dressing at all.

Keywords

dressing - hypospadias - wound - material - complications


Publication History

Received: 26 December 2022

Accepted: 02 March 2023

Accepted Manuscript online:
07 March 2023

Article published online:
04 April 2023

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