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初次全髋关节和膝关节置换术后传统与现代手术敷料的随机对照试验

Randomized controlled trial of conventional versus modern surgical dressings following primary total hip and knee replacement.

作者信息

Langlois Jean, Zaoui Amine, Ozil Camille, Courpied Jean-Pierre, Anract Philippe, Hamadouche Moussa

机构信息

Department of Orthopaedic and Trauma Surgery, Hôpital Cochin, Université Paris-Descartes, Assistance Publique-Hôpitaux de Paris, 27 Rue du Faubourg St Jacques, 75014, Paris, France,

出版信息

Int Orthop. 2015 Jul;39(7):1315-9. doi: 10.1007/s00264-015-2726-6. Epub 2015 Mar 19.

Abstract

PURPOSE

We prospectively compared two types of dressing (conventional gauze-based versus absorbing hydrofibre) after primary total hip (THA) or knee (TKA) arthroplasties.

METHODS

Eighty candidates for THA (n = 40) or TKA (s = 40) were randomized: gauze-based versus hydrofibre absorbing (Aquacel®, ConvaTec). The two groups were comparable at baseline.

RESULTS

There was a statistically significant decrease of dressing changes in the hydrofibre group (p = 0.0006). Two patients from the conventional group presented minor wound complications. Nurses' satisfaction was significantly higher in the hydrofibre group considering the adherence (p = 0.04) and flexibility (p = 0.03). Patients experienced a higher satisfaction with respect to ease of movement (p = 0.01) in the hydrofibre group. The cosmetic appearance of the scars six weeks after surgery was found to be similar between groups.

CONCLUSIONS

Our findings support an overall improved comfort for the patients and the medical staff by using hydrofibre dressings after primary THA and TKA. The reduction of required dressing changes was observed also.

摘要

目的

我们前瞻性地比较了初次全髋关节置换术(THA)或全膝关节置换术(TKA)后两种类型的敷料(传统纱布敷料与吸水性水凝胶纤维敷料)。

方法

80例拟行THA(n = 40)或TKA(n = 40)的患者被随机分组:一组使用基于纱布的敷料,另一组使用吸水性水凝胶纤维敷料(康维德公司的爱康肤银敷料)。两组在基线时具有可比性。

结果

水凝胶纤维敷料组的换药次数有统计学意义的显著减少(p = 0.0006)。传统敷料组有2例患者出现轻微伤口并发症。考虑到敷料的粘附性(p = 0.04)和柔韧性(p = 0.03),水凝胶纤维敷料组护士的满意度显著更高。水凝胶纤维敷料组患者在活动便利性方面的满意度更高(p = 0.01)。术后六周两组间瘢痕的外观相似。

结论

我们的研究结果表明,初次THA和TKA术后使用水凝胶纤维敷料能总体上提高患者和医护人员的舒适度。同时也观察到所需换药次数的减少。

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