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
