Department of Orthopedic Surgery, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University, College of Medicine, Kaohsiung, Taiwan.
Institution of Public Health, National Yang-Ming University, Taipei, Taiwan.
Biomed Res Int. 2017;2017:1262108. doi: 10.1155/2017/1262108. Epub 2017 Aug 2.
The use of modern surgical dressings to prevent wound complications and surgical site infection (SSI) after minimally invasive total knee arthroplasty (MIS-TKA) is lacking. In a prospective, randomized, controlled study, 240 patients were randomized to receive either AQUACEL Ag Surgical dressing (study group) or a standard dressing (control group) after MIS-TKA. The primary outcome was wound complication (SSI and blister). The secondary outcomes were wear time and number of dressing changes in the hospital and patient satisfaction (pain, comfort, and ease of use). In the intention-to-treat analysis, there was a significant reduction in the incidence of superficial SSI (0.8%, 95% CI∶ 0.00-2.48) in the study group compared to 8.3% (95% CI∶ 3.32-13.3) in the control group ( = 0.01). There were no differences in blister and deep/organ-space SSIs between the two groups. Multivariate analysis revealed that AQUACEL Ag Surgical dressing was an independent risk factor for reduction of SSI (odds ratio: 0.07, 95% CI: 0.01-0.58, = 0.01). The study group had longer wear time (5.2 ± 0.7 versus 1.7 ± 0.4 days, < 0.0001) and lower number of dressing changes (1.0 ± 0.2 versus 3.6 ± 1.3 times, < 0.0001). Increased patient satisfaction ( < 0.0001) was also noted in the study group. AQUACEL Ag Surgical dressing is an ideal dressing to provide wound care efficacy, patient satisfaction, reduction of SSI, and cost-effectiveness following MIS-TKA.
在微创全膝关节置换术(MIS-TKA)后,使用现代外科敷料来预防伤口并发症和手术部位感染(SSI)的做法并不常见。在一项前瞻性、随机、对照研究中,240 名患者被随机分为接受 AQUACEL Ag 外科敷料(研究组)或标准敷料(对照组)的两组。主要结局是伤口并发症(SSI 和水疱)。次要结局是在医院的佩戴时间和更换敷料的次数以及患者满意度(疼痛、舒适度和使用方便性)。在意向治疗分析中,与对照组(8.3%,95%CI:3.32-13.3)相比,研究组的浅表 SSI 发生率(0.8%,95%CI:0.00-2.48)显著降低( = 0.01)。两组之间的水疱和深部/器官间隙 SSI 无差异。多变量分析显示,AQUACEL Ag 外科敷料是 SSI 减少的独立危险因素(比值比:0.07,95%CI:0.01-0.58, = 0.01)。研究组的佩戴时间更长(5.2 ± 0.7 天 vs. 1.7 ± 0.4 天, < 0.0001),更换敷料的次数更少(1.0 ± 0.2 次 vs. 3.6 ± 1.3 次, < 0.0001)。研究组的患者满意度也更高( < 0.0001)。AQUACEL Ag 外科敷料是一种理想的敷料,可在 MIS-TKA 后提供伤口护理效果、患者满意度、降低 SSI 和成本效益。