Postoperative Dressing Management After Orchidopexy for Testicular Torsion
Yes, you should remove the dressing after a minimum of 48 hours following orchidopexy for testicular torsion, unless leakage occurs earlier, at which point it should be changed promptly. 1
Initial 48-Hour Period
Keep the surgical wound dressing undisturbed for at least 48 hours after surgery unless leakage or significant drainage occurs. 1 This recommendation applies to all primarily closed surgical wounds, including orchidopexy procedures.
The 48-hour threshold is based on the time required for the wound to become impermeable to microorganisms and establish initial skin continuity. 1
If leakage, bleeding, or saturation of the dressing occurs before 48 hours, change the dressing promptly using sterile technique. 1, 2 Allowing a saturated dressing to remain increases infection risk.
After 48 Hours
Remove the initial dressing after 48 hours and transition to daily wound inspection. 2 There is no evidence that extending dressing time beyond 48 hours reduces surgical site infections. 1
After removal, implement daily incision washing with chlorhexidine solution (0.5-2% alcoholic chlorhexidine) to reduce surgical site infection risk. 2
The wound can remain uncovered after 48 hours if there is no ongoing drainage, as the skin barrier has been re-established. 1
Special Considerations for Orchidopexy
Orchidopexy in boys under 1 year of age is associated with a higher wound infection rate (11% vs 2.4% in older boys), making meticulous wound monitoring particularly important in this age group. 3 This heightened infection risk makes the 48-hour dressing protocol even more critical.
The overall wound complication rate after orchidopexy is low (approximately 3% for testicular atrophy), but wound infections do occur and require early detection. 3
Use proper hand antisepsis and aseptic non-touch technique when removing or changing dressings. 2
Dressing Type Selection
Either sterile gauze or sterile transparent semipermeable dressings are appropriate for the initial postoperative period. 2
If visible exudate or bleeding is present, gauze dressings are preferable and may require replacement every 2 days until drainage resolves. 2
Transparent dressings allow continuous visual inspection without removal, which can be advantageous for monitoring healing in the scrotal area. 2
Common Pitfalls to Avoid
Do not use advanced dressings (hydrocolloids, foam, antimicrobial dressings) for routine primarily closed surgical wounds, as they provide no benefit over standard dressings in preventing surgical site infections. 1
Avoid leaving dressings in place beyond 48 hours based on outdated tradition rather than evidence—this increases cost without improving outcomes. 1, 4
Do not apply tape directly to scrotal or perineal skin when securing dressings; use gauze or tubular bandages instead to prevent skin trauma. 5
Monitoring for Complications
Monitor for signs of surgical site infection including increased pain, erythema, purulent drainage, fever, or wound separation. 2, 5 These signs warrant immediate evaluation regardless of dressing status.
The wound infection rate is higher in younger patients (under 1 year), so maintain heightened vigilance in this population. 3