Polyester mesh dressings reduce delayed wound healing rates after total hip arthroplasty compared with silver-impregnated occlusive dressings.

Dressings Total hip arthroplasty Wound-healing complications

Journal

Arthroplasty today
ISSN: 2352-3441
Titre abrégé: Arthroplast Today
Pays: United States
ID NLM: 101681808

Informations de publication

Date de publication:
Jun 2020
Historique:
received: 14 11 2019
revised: 27 01 2020
accepted: 29 01 2020
entrez: 6 5 2020
pubmed: 6 5 2020
medline: 6 5 2020
Statut: epublish

Résumé

New dressings purport to reduce surgical wound complications after total hip arthroplasty (THA). This study compared delayed wound healing rates and reoperations between 2 increasingly popular dressings: a silver-impregnated occlusive (standard) dressing and a 2-octyl cyanoacrylate adhesive with polyester mesh. This retrospective cohort study reviewed 431 consecutive THAs performed by 2 surgeons between January 2017 and May 2019. One hundred and eight were excluded for not using standard or mesh dressings. A final 323 cases were separated into 2 cohorts: mesh (n = 186) and standard dressings (n = 137). Standard dressings were removed at 1 week. Mesh persisted until nonadherent, approximately 3-4 weeks. The surgeon assessed delayed wound healing at the 2-week postoperative visit. Secondary outcomes include deep infection and return to the operating room for a wound-related diagnosis. Differences were determined using the chi-square test. There were no demographic, comorbidity, or surgical differences between groups. There were 22 total cases of delayed wound healing with 7 (3.8%) in the mesh group and 15 (10.9%) in the standard dressing group ( Mesh dressings are a safe and reliable dressing type for THA and were associated with a decrease in early wound healing complications when compared with standard, silver-impregnated occlusive dressings in this retrospective series. The mesh tension sharing properties and longer duration of occlusive protection may explain this difference. Level III.

Sections du résumé

BACKGROUND BACKGROUND
New dressings purport to reduce surgical wound complications after total hip arthroplasty (THA). This study compared delayed wound healing rates and reoperations between 2 increasingly popular dressings: a silver-impregnated occlusive (standard) dressing and a 2-octyl cyanoacrylate adhesive with polyester mesh.
METHODS METHODS
This retrospective cohort study reviewed 431 consecutive THAs performed by 2 surgeons between January 2017 and May 2019. One hundred and eight were excluded for not using standard or mesh dressings. A final 323 cases were separated into 2 cohorts: mesh (n = 186) and standard dressings (n = 137). Standard dressings were removed at 1 week. Mesh persisted until nonadherent, approximately 3-4 weeks. The surgeon assessed delayed wound healing at the 2-week postoperative visit. Secondary outcomes include deep infection and return to the operating room for a wound-related diagnosis. Differences were determined using the chi-square test.
RESULTS RESULTS
There were no demographic, comorbidity, or surgical differences between groups. There were 22 total cases of delayed wound healing with 7 (3.8%) in the mesh group and 15 (10.9%) in the standard dressing group (
CONCLUSIONS CONCLUSIONS
Mesh dressings are a safe and reliable dressing type for THA and were associated with a decrease in early wound healing complications when compared with standard, silver-impregnated occlusive dressings in this retrospective series. The mesh tension sharing properties and longer duration of occlusive protection may explain this difference.
LEVEL OF EVIDENCE METHODS
Level III.

Identifiants

pubmed: 32368604
doi: 10.1016/j.artd.2020.01.013
pii: S2352-3441(20)30013-3
pmc: PMC7184099
doi:

Types de publication

Journal Article

Langues

eng

Pagination

158-162

Informations de copyright

© 2020 The Authors.

Références

J Arthroplasty. 2018 Apr;33(4):1166-1170
pubmed: 29248486
Aesthetic Plast Surg. 2013 Jun;37(3):529-37
pubmed: 23613192
Biomed Res Int. 2017;2017:1262108
pubmed: 28831390
Orthopedics. 2017 Sep 1;40(5):e784-e787
pubmed: 28598492
J Arthroplasty. 2017 Mar;32(3):929-932
pubmed: 27776905
J Arthroplasty. 2014 Jun;29(6):1098-100
pubmed: 24405622
Clinicoecon Outcomes Res. 2018 Dec 17;11:1-11
pubmed: 30588049
J Wound Care. 2018 Apr 1;27(Sup4):S12-S22
pubmed: 29641342
J Arthroplasty. 2016 Jul;31(7):1561-7
pubmed: 26872587
J Wound Care. 2016 Jan;25(1):40, 42-5
pubmed: 26762497
Clin Orthop Relat Res. 2008 Jul;466(7):1710-5
pubmed: 18421542
Sci Rep. 2016 Jan 25;6:19764
pubmed: 26805714
Allergy. 2010 Jun 1;65(6):798-9
pubmed: 19909297
Dermatitis. 2016 Mar-Apr;27(2):75-6
pubmed: 26983096
J Arthroplasty. 2014 Feb;29(2):283-7
pubmed: 24275262
Ann Plast Surg. 2014 Dec;73(6):631-7
pubmed: 23722581
Am J Infect Control. 2013 Mar;41(3):221-6
pubmed: 22999770
J Arthroplasty. 2008 Oct;23(7):984-91
pubmed: 18534466
Int Orthop. 2015 Nov;39(11):2091-6
pubmed: 26381908
Am J Orthop (Belle Mead NJ). 2010 Oct;39(10):476-8
pubmed: 21290007
Int Orthop. 2017 Jul;41(7):1295-1305
pubmed: 28493210
Ann Ig. 2017 Sep-Oct;29(5):422-430
pubmed: 28715055
J Arthroplasty. 2016 May;31(5):1047-52
pubmed: 26712346

Auteurs

Carl L Herndon (CL)

Center for Hip and Knee Replacement, Department of Orthopedic Surgery, Columbia University Irving Medical Center, New York, NY, USA.

Josephine R Coury (JR)

Center for Hip and Knee Replacement, Department of Orthopedic Surgery, Columbia University Irving Medical Center, New York, NY, USA.

Nana O Sarpong (NO)

Center for Hip and Knee Replacement, Department of Orthopedic Surgery, Columbia University Irving Medical Center, New York, NY, USA.

Jeffrey A Geller (JA)

Center for Hip and Knee Replacement, Department of Orthopedic Surgery, Columbia University Irving Medical Center, New York, NY, USA.

Roshan P Shah (RP)

Center for Hip and Knee Replacement, Department of Orthopedic Surgery, Columbia University Irving Medical Center, New York, NY, USA.

H John Cooper (HJ)

Center for Hip and Knee Replacement, Department of Orthopedic Surgery, Columbia University Irving Medical Center, New York, NY, USA.

Classifications MeSH