Raising standards of orthopaedic wound care: a prospective, comparative evaluation of a modern dressing design

J.V. Clarke, J.M. Dillon, R.L. Sayer, I.P. McLean

Research output: Contribution to journalConference Contribution

Abstract

Introduction: Prevention of infection in orthopaedics remains a constant challenge. In spite of increasing evidence to support use of modern dressings many units use traditional adhesive dressings, which can cause wound healing problems. Our modern dressing design hydrofibre/hydrocolloid (HF/HC) was highly effective following hip and knee replacements in a national arthroplasty unit. The aim of this study was to evaluate this dressing in a district hospital to see if similar clinical outcomes could be achieved.
Methods: Prospective evaluation of the modern dressing involved 89 consecutive elective and trauma patients from October 2007–January 2008. Outcome measures included blistering, wear time, dressing changes, delayed discharge and SSI rate. Results were compared to a traditional dressing currently used.
Results: 65 patients HF/HC group, 24 Traditional group. CUSUM tool set an upper alert limit of 5% blister rate. Traditional group breached upper alert limit after 8 cases. It was decided unethical to continue after 24 cases. Comparison of HF/HC with Traditional showed blistering 1.5% versus 16.7%, wear time 4.8 versus 1.4 days and dressing changes 0.9 versus 2.8. Delayed discharge 0% compared with 4.2%. SSI rates 0% versus 4.2%. All outcome differences were statistically significant except delayed discharge (p<0.05, Mann Whitney, chi-square tests).
Conclusion: Implementation of evidence-based modern wound care into a district general orthopaedic department achieved improved clinical outcomes with elective and trauma patients, similar to those of a national arthroplasty unit.This supports the use of the dressing and highlights the ongoing concerns of traditional dressings used in orthopaedics.
LanguageEnglish
PagesA69
Number of pages1
JournalWound Repair and Regeneration
Volume16
Issue number6
Early online date27 Oct 2008
DOIs
Publication statusPublished - 31 Dec 2008
EventEuropean Tissue Repair Society: Joint Meeting with the Tissue Viability Unit of Malta - St George's Bay, Malta
Duration: 10 Sep 200812 Sep 2008

Fingerprint

Bandages
Orthopedics
Wounds and Injuries
Colloids
Arthroplasty
District Hospitals
Chi-Square Distribution
Blister
Adhesives
Wound Healing
Hip
Knee
Outcome Assessment (Health Care)

Keywords

  • wound care
  • dressing
  • orthopaedics
  • hospital

Cite this

Clarke, J.V. ; Dillon, J.M. ; Sayer, R.L. ; McLean, I.P. / Raising standards of orthopaedic wound care : a prospective, comparative evaluation of a modern dressing design. In: Wound Repair and Regeneration. 2008 ; Vol. 16, No. 6. pp. A69.
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abstract = "Introduction: Prevention of infection in orthopaedics remains a constant challenge. In spite of increasing evidence to support use of modern dressings many units use traditional adhesive dressings, which can cause wound healing problems. Our modern dressing design hydrofibre/hydrocolloid (HF/HC) was highly effective following hip and knee replacements in a national arthroplasty unit. The aim of this study was to evaluate this dressing in a district hospital to see if similar clinical outcomes could be achieved.Methods: Prospective evaluation of the modern dressing involved 89 consecutive elective and trauma patients from October 2007–January 2008. Outcome measures included blistering, wear time, dressing changes, delayed discharge and SSI rate. Results were compared to a traditional dressing currently used.Results: 65 patients HF/HC group, 24 Traditional group. CUSUM tool set an upper alert limit of 5{\%} blister rate. Traditional group breached upper alert limit after 8 cases. It was decided unethical to continue after 24 cases. Comparison of HF/HC with Traditional showed blistering 1.5{\%} versus 16.7{\%}, wear time 4.8 versus 1.4 days and dressing changes 0.9 versus 2.8. Delayed discharge 0{\%} compared with 4.2{\%}. SSI rates 0{\%} versus 4.2{\%}. All outcome differences were statistically significant except delayed discharge (p<0.05, Mann Whitney, chi-square tests).Conclusion: Implementation of evidence-based modern wound care into a district general orthopaedic department achieved improved clinical outcomes with elective and trauma patients, similar to those of a national arthroplasty unit.This supports the use of the dressing and highlights the ongoing concerns of traditional dressings used in orthopaedics.",
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Raising standards of orthopaedic wound care : a prospective, comparative evaluation of a modern dressing design. / Clarke, J.V.; Dillon, J.M.; Sayer, R.L.; McLean, I.P.

In: Wound Repair and Regeneration, Vol. 16, No. 6, 31.12.2008, p. A69.

Research output: Contribution to journalConference Contribution

TY - JOUR

T1 - Raising standards of orthopaedic wound care

T2 - Wound Repair and Regeneration

AU - Clarke, J.V.

AU - Dillon, J.M.

AU - Sayer, R.L.

AU - McLean, I.P.

PY - 2008/12/31

Y1 - 2008/12/31

N2 - Introduction: Prevention of infection in orthopaedics remains a constant challenge. In spite of increasing evidence to support use of modern dressings many units use traditional adhesive dressings, which can cause wound healing problems. Our modern dressing design hydrofibre/hydrocolloid (HF/HC) was highly effective following hip and knee replacements in a national arthroplasty unit. The aim of this study was to evaluate this dressing in a district hospital to see if similar clinical outcomes could be achieved.Methods: Prospective evaluation of the modern dressing involved 89 consecutive elective and trauma patients from October 2007–January 2008. Outcome measures included blistering, wear time, dressing changes, delayed discharge and SSI rate. Results were compared to a traditional dressing currently used.Results: 65 patients HF/HC group, 24 Traditional group. CUSUM tool set an upper alert limit of 5% blister rate. Traditional group breached upper alert limit after 8 cases. It was decided unethical to continue after 24 cases. Comparison of HF/HC with Traditional showed blistering 1.5% versus 16.7%, wear time 4.8 versus 1.4 days and dressing changes 0.9 versus 2.8. Delayed discharge 0% compared with 4.2%. SSI rates 0% versus 4.2%. All outcome differences were statistically significant except delayed discharge (p<0.05, Mann Whitney, chi-square tests).Conclusion: Implementation of evidence-based modern wound care into a district general orthopaedic department achieved improved clinical outcomes with elective and trauma patients, similar to those of a national arthroplasty unit.This supports the use of the dressing and highlights the ongoing concerns of traditional dressings used in orthopaedics.

AB - Introduction: Prevention of infection in orthopaedics remains a constant challenge. In spite of increasing evidence to support use of modern dressings many units use traditional adhesive dressings, which can cause wound healing problems. Our modern dressing design hydrofibre/hydrocolloid (HF/HC) was highly effective following hip and knee replacements in a national arthroplasty unit. The aim of this study was to evaluate this dressing in a district hospital to see if similar clinical outcomes could be achieved.Methods: Prospective evaluation of the modern dressing involved 89 consecutive elective and trauma patients from October 2007–January 2008. Outcome measures included blistering, wear time, dressing changes, delayed discharge and SSI rate. Results were compared to a traditional dressing currently used.Results: 65 patients HF/HC group, 24 Traditional group. CUSUM tool set an upper alert limit of 5% blister rate. Traditional group breached upper alert limit after 8 cases. It was decided unethical to continue after 24 cases. Comparison of HF/HC with Traditional showed blistering 1.5% versus 16.7%, wear time 4.8 versus 1.4 days and dressing changes 0.9 versus 2.8. Delayed discharge 0% compared with 4.2%. SSI rates 0% versus 4.2%. All outcome differences were statistically significant except delayed discharge (p<0.05, Mann Whitney, chi-square tests).Conclusion: Implementation of evidence-based modern wound care into a district general orthopaedic department achieved improved clinical outcomes with elective and trauma patients, similar to those of a national arthroplasty unit.This supports the use of the dressing and highlights the ongoing concerns of traditional dressings used in orthopaedics.

KW - wound care

KW - dressing

KW - orthopaedics

KW - hospital

UR - http://onlinelibrary.wiley.com/journal/10.1111/(ISSN)1524-475X

U2 - 10.1111/j.1524-475X.2008.00424.x

DO - 10.1111/j.1524-475X.2008.00424.x

M3 - Conference Contribution

VL - 16

SP - A69

JO - Wound Repair and Regeneration

JF - Wound Repair and Regeneration

SN - 1067-1927

IS - 6

ER -