Lawo Kristin, Feller Dominique, Klein Birgit S, Holland-Cunz Stefan G, Frech-Dörfler Martina
Department of Pediatric Surgery, University Children's Hospital Basel, Basel, Switzerland.
University of Basel, Basel, Switzerland.
Pediatr Surg Int. 2025 Jun 18;41(1):176. doi: 10.1007/s00383-025-06063-1.
Dressing technique after hypospadias repair is one of the most controversially discussed subjects in the aftercare. Although current literature presents an enormous number of publications regarding postoperative dressing techniques, there is still no consent on how and if to perform postoperative dressing. The aim of this study is to evaluate two techniques (circular film dressing vs. silver pad covered with film dressing) frequently used in clinical routine after hypospadias surgery.
Primary outcomes of this prospective randomized clinical trial were wound healing using Southampton Wound Assessment Scale (SWAS) and cosmetic and functional result using Hypospadias Objective Penile Evaluation (HOPE)-Score. Secondary outcomes were postoperative adverse events.
44 patients were included and randomized into two groups (n = 24 for film dressing vs. n = 20 silver pad dressing). Concerning the primary outcomes, no significant difference in SWAS and HOPE score could be shown. Secondary outcomes showed a statistically significant higher rate of wound dehiscence in the silver pad group and no other statistically significant differences.
This study could not show superiority of one dressing regarding wound healing or functional and cosmetic result and thereby strengthens the assumption that the individual dressing technique does not play a crucial role in the postoperative outcome.
尿道下裂修复术后的包扎技术是术后护理中讨论最具争议的话题之一。尽管当前文献中有大量关于术后包扎技术的出版物，但对于如何进行以及是否进行术后包扎仍未达成共识。本研究的目的是评估尿道下裂手术后临床常规常用的两种技术（圆形薄膜敷料与覆盖薄膜敷料的银垫）。
这项前瞻性随机临床试验的主要结局是使用南安普顿伤口评估量表（SWAS）评估伤口愈合情况，以及使用尿道下裂客观阴茎评估（HOPE）评分评估外观和功能结果。次要结局是术后不良事件。
纳入44例患者并随机分为两组（薄膜敷料组n = 24，银垫敷料组n = 20）。关于主要结局，SWAS和HOPE评分未显示出显著差异。次要结局显示银垫组伤口裂开率在统计学上显著更高，且无其他统计学显著差异。
本研究未能显示出一种敷料在伤口愈合或功能及外观结果方面的优越性，从而强化了这样一种假设，即个体包扎技术在术后结局中并不起关键作用。
