A Prospective, Randomised, Controlled Trial Comparing Wound Dressings Used in Hip and Knee Surgery: Aquacel and Tegaderm Versus Cutiplast

Abstract

INTRODUCTION Cutiplast (absorbent perforated dressing with adhesive border; Smith & Nephew) is commonly used following orthopaedic operation, but complications of its use have been reported. A prospective, randomised, controlled study was performed to compare the efficacy of Cutiplast versus an Aquacel (hydrofibre dressing; ConvaTec) covered with Tegaderm (vapourpermeable dressing; 3M).PATIENTS AND METHODS Two-hundred patients were randomised to receive one of the two dressings following elective and nonelective surgery of the hip and the knee. We were able to study 183 patients. The condition of the wound and any complications such as skin blistering or signs of infection was noted as was the frequency of dressing changes. RESULTS The Aquacel and Tegaderm dressing was 5.8 times more likely to result in a wound with no complications as compared to a Cutiplast dressing (odds ratio, 5.8; 95% CI 2.8-12.5; P < 0.00001).CONCLUSION Aquacel covered by Tegaderm is a superior dressing to Cutiplast following surgery to the hip and knee.

Bio-Occlusive Gauze with Tegaderm: A Dressing for Surgical Wounds in Primary THA and TKA

“…Only 1 patient required 1 unit of fresh frozen plasma preoperatively for known coagulopathy and cirrhosis. The average incision length was 12.4 cm (range [10][11][12][13][14][15][16]. The average number of Tegaderm films used was 5.3 (range 5-7).…”

“…The wound exudate is rich in IL-1, PDGF, EGF, and TGF-beta, all of which modulate connective tissue formation and epidermal migration [14]. Winter's research has demonstrated that a moist microenvironment enhances the wound healing process [15]. However, in some instances, some wounds can be highly exudative with persistent leakage.…”

A review of blisters caused by wound dressing components: Can they impede post-operative rehabilitation and discharge?

“…Postoperative peri-wound blistering is a well-recognised phenomenon in orthopaedic surgery (Lawrentschuk et al, 2002;Ravenscroft et al, 2006;Koval et al, 2007;Tustanowski, 2009;Burke et al, 2012). This is because wound dressings are applied over joints that move and cause dressing skin interactions that lead to shear and/or friction episodes and thus blister formation.…”

“…Thoughts are divided as to whether blisters should be maintained intact or burst (Dearden et al, 2001;Murphy and Amblum, 2014), but blisters associated with wounds have been identified as the main cause for topical wound and skin infections in patients undergoing amputation (Harker, 2006). Some research has identified that the main problems with surgical wounds following hip and knee surgery are blistering and infection, specifically if dressings are applied for a long period (Ravenscroft et al, 2006).…”

“…It is the view of the authors that additional complications occur in patients with post-surgical wounds who develop blisters when pain might be exacerbated by repeated application and removal of dressings. Also, there is a high risk of blister de-roofing and subsequent infection (Ravenscroft et al, 2006). As a consequence of this pain, there might be a detrimental effect on postoperative physiotherapy and rehabilitation.…”