evaluation of ioband coverage waterproof dressing versus isolated waterproof dressing after primary total knee arthroplasty

Conditions: Postoperative Wound Care After TKA

Summary: title: evaluation of ioband® coverage waterproof dressing in post-operative total knee arthroplasty (tka) goal: to evaluate the effectiveness of ioband® coverage waterproof dressing compared to standard waterproof dressing in reducing dressing change frequency and peel-off degree post-op tka. main research questions: 1. does ioband® coverage waterproof dressing significantly decrease the degree of peel-off compared to standard waterproof dressing? 2. does ioband® coverage reduce the number of wound dressing changes required post-operatively? 3. does ioband® coverage improve overall patient satisfaction compared to standard waterproof dressing? participants: participants will include patients who have undergone total knee arthroplasty (tka). main tasks and interventions: 1. randomization: participants will be randomly assigned to receive either the ioband® coverage waterproof dressing or the standard waterproof dressing. 2. application of dressings: participants will have the assigned dressing applied to their surgical site post-operatively. 3. assessment of peel-off degree: participants will undergo assessments to evaluate the degree of peel-off of the dressing over a specified time. 4. wound dressing changes: participants will have their dressing changed as per routine care protocols, with documentation of the number of changes. 5. patient satisfaction survey: participants will complete a satisfaction survey to assess their experiences with the dressing and overall comfort. conclusion: the trial aims to provide insights into the benefits of ioband® coverage waterproof dressing in improving post-operative care for tka patients, focusing on key outcomes related to dressing performance and patient satisfaction.

study design: * participants: 96 patients undergoing tka, randomly assigned to two groups of 48 each: * intervention group: ioband® coverage waterproof dressing * control group: standard waterproof dressing (opsite®) randomization method: -computerized block randomization performed by an independent research assistant. pre-operative procedures: * pre-emptive analgesia administered 1 hour before surgery included: 1. naproxen (250 mg) 2. omeprazole (20 mg) 3. acetaminophen (500 mg) 4. pregabalin (75 mg) anesthesia: administered spinal anesthesia and ultrasound-guided adductor canal block by experienced anesthesiologists. surgical preparation: * incision sites were prepped and draped using sterile technique. * antiseptic ioband® (60×45 cm) covered the incision site to prevent contamination. surgical technique: * utilization of a standard medial parapatellar approach with a minimally invasive tka technique. * a tourniquet was inflated to 100 mmhg above systolic blood pressure and was deflated after wound closure. * cemented posterior stabilizer prosthetics (nexgen lps) and patellar resurfacing were used. * anesthetic cocktail (0.5% bupivacaine, adrenaline, ketorolac, morphine) was injected around the capsule after prosthesis insertion. post-operative care: * no suction drains or extremity wraps used. * wounds closed with waterproof dressing (opsite® size 25×10 cm) in 90-degree knee flexion without tension. * pain management: multimodal pain control was employed. * antibiotic prophylaxis: administered for 24 hours post-surgery. * rehabilitation: early knee range of motion exercises and ambulation were encouraged within 24 hours post-operation. wound management protocol: * patients were allowed to start bathing 48 hours post-op. * dressing change on post-op day 3, using sterile technique: * control group: covered with waterproof dressing (opsite®). * intervention group: covered with ioband® in knee flexion. wound care instructions: * keep covering material dry and clean; avoid irritation. * report any signs of infection (redness, swelling, fever) to a doctor. * avoid creams or powders unless prescribed. * avoid scratching or rubbing around the wound. * light activities permitted; avoid strenuous activities for 6 weeks. * dressing should not be changed until advised, typically after 14 days unless signs of complications are observed. criteria for dressing change: * change dressing if: * first waterproof dressing peels off grade ii or iii. * second dressing has over 50% bleeding. * suspected surgical site infection. patients were also included in a chat group for wound care consultation.

Eligibility criteria:
inclusion criteria: * primary unilateral tka * age 55-80 yrs exclusion criteria: * chronic skin disease such as psoriasis * chronic steroid use * allergy to skin adhesive, cover wound * robotic tka * iodine allergy * not follow protocol

Keywords: total knee arthroplasty ioband® coverage waterproof dressing