A prospective randomized trial of the effect of a soluble adhesive on the ease of dressing removal following hypospadias repair

Abstract

Aim To determine whether the use of a novel dressing removal technique resulted in shorter removal times, reduced the child's experience of pain and/or reduced parental anxiety when compared to a standard approach. Methods This prospective unblinded randomized controlled trial of 53 consecutive boys undergoing primary hypospadias repair was powered using data from a prior feasibility study. Children were randomized to a standard control dressing (A) or standard dressing plus Cavilon™ (B) group. Removal was by (A) soaking the child and dressing in the bath or (B) application of an adhesive remover to the dressing. The primary outcome measure was dressing removal time. Secondary measures were: child pain scores on a visual analogue scale measured by the parent and nurse, and parental anxiety using the self-evaluative state anxiety measure. Data are expressed as median (range); P < 0.05 is significant. Results Dressing B was significantly quicker to remove than A: B 30 min (5–86 min) vs A 40 min (17–105 min), P = 0.01, Mann–Whitney. No differences in parent/nurse pain scores between the two groups were seen. There was a strong correlation between parent and nurse reporting of pain scores at the time of dressing removal (Spearman 0.79, P < 0.000). No significant differences in pre- and post-dressing removal parental anxiety scores were seen ( P = 0.159, Mann–Whitney). Several parents had high anxiety levels at both times. Conclusion The novel dressing removal approach (B) was significantly shorter than the standard one (A). There were no significant differences in child's pain or parental anxiety score between the two approaches.