Khanzada Muhammad Azfar, Awadelkarim Omer Adil, Abdel Rahman Tarig, Ghandour Adel
Orthopedics, Dr. Sulaiman Al Habib Suwaidi Hospital, Riyadh, SAU.
Orthopedics/Anesthesiology, Dr. Sulaiman Al Habib Suwaidi Hospital, Riyadh, SAU.
Cureus. 2023 Apr 19;15(4):e37820. doi: 10.7759/cureus.37820. eCollection 2023 Apr.
To evaluate surgical outcomes using sets of techniques to achieve single dry dressing for two weeks post total knee replacement (TKR) at Dr. Sulaiman Al-Habib Hospital, Riyadh, Saudi Arabia.
A prospective study comprised of 110 consecutive unilateral total knee replacements was conducted at the orthopedic department of Dr. Sulaiman Al-Habib Hospital, Suwaidi, Riyadh, KSA. Patients of both genders underwent knee replacement surgery due to primary knee osteoarthritis, Kellgren-Lawrence grades 3 and 4. Routine investigations and fitness evaluations of patients were carried out preoperatively. Preoperative minimal use of a tourniquet and release prior to arthrotomy closure; intravenous tranexamic acid, no drains; capsule infiltration with local anesthetics without adrenaline; tight closure with barbed sutures up to the skin in three layers; skin glue; Aquacel dressing; adductor canal block; and continuation of oral anticoagulant for four weeks.
A total of 110 cases were included, of which 81 (73.6%) were females and 29 (26.4%) were males. The mean age of the study population was 60.5+10.3 years (48 to 88 years). The mean BMI in our patients was 30.57+10.5 kg/m. Most patients were morbidly obese 13 (30.95%). The mean preoperative Hb% was 13.07+1.6 g/dl, while the mean postoperative Hb% was 12.58+1.9 mg/dl with a p-value of 0.28, which was non-significant statistically. Only two patients needed a change of Aquacel wound dressing for ooze. None of our patients developed deep venous thrombosis (DVT) or an infection.
A sequential use of sets of techniques is observed to be associated with improved outcomes in terms of blood loss, wound infection, mobility, and patient satisfaction, leading to the ultimate end point of dry Aquacel wound dressing.
在沙特阿拉伯利雅得的苏莱曼·哈比卜博士医院，评估采用一系列技术在全膝关节置换术（TKR）后实现两周单次干敷料的手术效果。
在沙特阿拉伯利雅得苏瓦迪的苏莱曼·哈比卜博士医院骨科进行了一项前瞻性研究，纳入110例连续的单侧全膝关节置换术患者。因原发性膝关节骨关节炎（Kellgren-Lawrence 3级和4级），男女患者均接受了膝关节置换手术。术前对患者进行了常规检查和健康评估。术前尽量少用止血带并在关节切开术关闭前松开；静脉注射氨甲环酸，不放置引流管；用不含肾上腺素的局部麻醉剂进行关节囊浸润；用倒刺缝线分三层紧密缝合直至皮肤；使用皮肤胶水；使用爱康肤银敷料；进行内收肌管阻滞；并持续四周口服抗凝剂。
共纳入110例病例，其中81例（73.6%）为女性，29例（26.4%）为男性。研究人群的平均年龄为60.5±10.3岁（48至88岁）。我们患者的平均体重指数为30.57±10.5kg/m²。大多数患者为病态肥胖（占30.�5%）。术前平均血红蛋白百分比为13.07±1.6g/dl，术后平均血红蛋白百分比为12.58±1.9mg/dl，p值为0.28，在统计学上无显著意义。只有两名患者因渗液需要更换爱康肤伤口敷料。我们的患者均未发生深静脉血栓形成（DVT）或感染。
观察到一系列技术的顺序使用在失血、伤口感染、活动能力和患者满意度方面具有更好的效果，从而实现爱康肤伤口干敷料这一最终目标。
