Applying dressings to wounds is a common practice throughout the world, both in and out of hospitals. At times, removing such dressings can be more painful than the wound itself.1 Research on dressing removal has often focused on expensive new products2 and, although speed of dressing removal has been controlled for in some studies2 (implying that speed is a factor), we are not aware of any research directed specifically at different speeds of dressing removal. There are Internet sites addressing how to reduce the pain associated with removal of certain brands of dressings, such as Band-Aid (Johnson & Johnson, New Brunswick, NJ, USA) (eg, http://www.wikihow.com/Remove-a-Band-Aid); however, there is no consensus on the issue of speed.

The pain of dressing removal is thought to be related to the mechanical stripping of the stratum corneum from the underlying epidermal and dermal cells.3 However, the perception of pain is complex — it is a multifactorial experience influenced by culture, previous pain events, beliefs, mood and ability to cope.4
The study was a prospective, randomised, crossover trial comparing FBAR with SBAR in healthy volunteers. It was conducted on 4 August 2009 at James Cook University, Townsville, Queensland.
The study protocol was approved by the Townsville Health Service District Institutional Ethics Committee and conforms to the provisions of the Declaration of Helsinki.5 There was no manufacturer involvement in the study.
Sixty-five participants were included in the study, of whom 35 were female (54%) and 48 were of European ancestry (74%); the mean age of participants was 20.1 years (range 18–30 years). Most participants (49/65; 75%) believed that SBAR would be more painful than FBAR. The mean body hair score for men was 2.1 and the mean for women was 1.3 (P < 0.001).
Our results show that FBAR was less painful than SBAR. This is consistent with the preconceptions of most of our sample. A high body hair score was, not surprisingly, associated with higher pain scores, and it seemed that preconceptions also had an appreciable effect. Several other aspects of our data may require further investigation. The pain experience is a complex and incompletely understood process that incorporates many aspects of patients’ social and cultural beliefs, as well as previous experiences.4 Our observation that preconceptions were associated with pain scores should not therefore be surprising.
Our study had other limitations. These included the inability to blind the participants (in terms of which removal technique and which side of the body would be tested first) and preconceived ideas regarding the technique that would be more painful, both of which may have biased our results. However, the use of randomisation and a crossover design should have minimised this inherent bias. In addition, scoring pain is an imprecise science and there is no perfect pain assessment tool. The verbal numeric pain scale is a commonly used pain assessment tool and has been validated for use in emergency settings.6 It is possible that it may be less reliable and reproducible at the lower ends of the pain scale.
Abstract
Objective: To determine whether slow or fast bandaid removal is less painful.
Design, setting and participants: A prospective, randomised, crossover trial was carried out at James Cook University, Townsville. Participants were healthy volunteers from Years 2 and 3 of the James Cook University medical school program.
Interventions: Medium-sized bandaids were applied bilaterally in three standard body locations and removed using slow and fast techniques.
Main outcome measures: Pain scores were assessed using an 11-point verbal numeric pain scale.
Results: 65 participants were included in the study. The overall mean pain score for fast bandaid removal was 0.92 and for slow bandaid removal was 1.58. This represents a highly significant difference of 0.66 (P < 0.001).
Conclusion: In young healthy volunteers, fast bandaid removal caused less pain than slow bandaid removal.