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Enhancing patient recovery following lower limb arthroplasty with a modern wound dressing: a prospective, comparative audit.
MedLine Citation:
PMID:  22584680     Owner:  NLM     Status:  In-Data-Review    
Abstract/OtherAbstract:
Objective: To assess current wound care practice, implement a potentially improved regimen and re-evaluate practice. Method: Two prospective clinical audits were performed over a 6-month period, involving 100 patients undergoing hip or knee arthroplasty. Fifty consecutive patients with traditional dressings (Mepore; Mölnlycke) were evaluated prior to a change in practice to a modern dressing (Aquacel Surgical; ConvaTec). Fifty consecutive patients were then evaluated with the new dressing to complete the audit cycle. Clinical outcome measures were wear time, number of changes, blister rate and length of hospital stay. Statistical comparisons were performed using Mann Whitney or Fisher's exact test (statistical significance p < 0.05). Results: Wear time for the traditional dressing (2 days) was significantly shorter than for the modern dressing (7 days; p < 0.001), and required more changes (0 vs 3; p < 0.001). Twenty per cent of patients developed blisters with the traditional dressing compared with 4% with the modern dressing (p=0.028). Median length of stay was the same for the modern dressing (4 days) compared with the traditional dressing (4 days). In the modern dressing group, 75% of patients were discharged by day 4, whereas in the traditional group this took until day 6. Conclusion: This audit highlights the problems associated with traditional dressings with frequent early dressing changes, blistering and delayed discharge. These adverse outcomes can be minimised with a modern dressing specifically designed for the demands of lower limb arthroplasty. Units planning to implement enhanced recovery regimens should consider adopting this dressing to avoid compromising patient discharge. Declaration of interest: There were no external sources of funding for this audit; however, one author (JC) received reimbursement of expenses to attend and present work at educational conferences from ConvaTec.
Authors:
G P Hopper; A H Deakin; E O Crane; J V Clarke
Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Journal of wound care     Volume:  21     ISSN:  0969-0700     ISO Abbreviation:  J Wound Care     Publication Date:  2012 Apr 
Date Detail:
Created Date:  2012-05-15     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9417080     Medline TA:  J Wound Care     Country:  England    
Other Details:
Languages:  eng     Pagination:  200-3     Citation Subset:  N    
Affiliation:
MBChB, ST1, Trauma and Orthopaedics.
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