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先进伤口敷料与传统伤口敷料在髋膝关节手术后骨科护理中的比较疗效:一项随机对照试验。

Comparative efficacy of advanced and traditional wound dressings in post-operative orthopaedic care for hip and knee surgeries: A randomized controlled trial.

作者信息

Srivastava Nidhi, Ghai Amresh, Goyal Meenu, Kumar Manoj, Kumar Manoj

机构信息

Orthopaedic Matron, Army Hospital (Research & Referral) New Delhi, New Delhi, India.

Orthopaedic Matron, Military Hospital, Secunderabad, India.

出版信息

J Clin Orthop Trauma. 2025 Feb 12;63:102933. doi: 10.1016/j.jcot.2025.102933. eCollection 2025 Apr.

Abstract

BACKGROUND

This randomized controlled study aimed to evaluate the efficacy of three advanced dressings (Aquacel Ag®, Opsite® Post-Op, and Mepilex Border Post-Op®) versus traditional dressings in post-operative care for patients undergoing orthopaedic hip or knee surgeries.

METHODS

Conducted between August and December 2022 at a tertiary care orthopaedic centre, 314 patients were randomized into four groups. Group A received Aquacel Ag®, Group B received Opsite® Post-Op, Group C received Mepilex Border Post-Op®, and Group D received traditional dressings. The primary outcomes measured were pain levels during dressing changes, exudate management, patient comfort, nurses' ease of application and removal of the dressing, and surgical site complications. Multivariate analysis, including logistic regression, was performed to adjust for potential confounders (ClinicalTrials.gov ID NCT06540040).

RESULTS

Mepilex Border Post-Op® (Group C) significantly outperformed other dressings in key areas. Pain levels during dressing changes were consistently lower in this group on Day 3 (3.5 ± 0.8 vs. 6.0 ± 1.1 in the traditional dressing group, p = 0.002) and at day 7 & 14 as well. Exudate management was effective with Mepilex Border Post-Op®. Group C patients reported the highest comfort and mobility scores on a Likert scale with easy application and removal. Surgical site complications were minimal, with only 1.2 % of Group C patients affected by Day 14 compared to 9.8 % in Group D (p = 0.003). Multivariate analysis confirmed that Mepilex Border Post-Op® significantly reduced surgical site complications and improved patient comfort, with adjusted odds ratios favouring this dressing over traditional options.

CONCLUSION

Mepilex Border Post-Op® (a 4-layer hydrophilic foam dressing) demonstrated benefits in post-operative care, reducing pain and complications while improving patient comfort. Single centre design with a limited sample size of the present study limits the generalizability of our findings. Further research is warranted to confirm these findings in broader clinical settings.

TRIAL REGISTRATION NUMBER

ClinicalTrials.gov ID NCT06540040.

摘要

背景

这项随机对照研究旨在评估三种高级敷料(爱康肤银藻酸盐敷料、术后使用的优赛透明敷料、美皮康术后边框敷料)与传统敷料相比,在接受骨科髋关节或膝关节手术患者术后护理中的疗效。

方法

2022年8月至12月在一家三级护理骨科中心进行,314名患者被随机分为四组。A组接受爱康肤银藻酸盐敷料,B组接受术后使用的优赛透明敷料,C组接受美皮康术后边框敷料,D组接受传统敷料。测量的主要结局包括换药时的疼痛程度、渗出液管理、患者舒适度、护士更换和移除敷料的难易程度以及手术部位并发症。进行了包括逻辑回归在内的多变量分析,以调整潜在的混杂因素(ClinicalTrials.gov标识符NCT06540040)。

结果

美皮康术后边框敷料(C组)在关键领域明显优于其他敷料。该组在第3天换药时的疼痛程度持续较低(传统敷料组为6.0±1.1,该组为3.5±0.8,p = 0.002),在第7天和第14天也是如此。美皮康术后边框敷料对渗出液管理有效。C组患者在李克特量表上报告的舒适度和活动能力得分最高,敷料易于应用和移除。手术部位并发症极少,到第14天,C组只有1.2%的患者受影响,而D组为9.8%(p = 0.003)。多变量分析证实,美皮康术后边框敷料显著降低了手术部位并发症并提高了患者舒适度,调整后的优势比表明该敷料优于传统敷料。

结论

美皮康术后边框敷料(一种四层亲水性泡沫敷料)在术后护理中显示出益处,可减轻疼痛和并发症,同时提高患者舒适度。本研究的单中心设计和有限的样本量限制了我们研究结果的普遍性。有必要进行进一步研究以在更广泛的临床环境中证实这些结果。

试验注册号

ClinicalTrials.gov标识符NCT06540040。

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