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2023, Vol. 27 ›› Issue (3): 486-492

Systematic evaluation of six dressings on wound safety following total hip and knee arthroplasty

You Aijia, Li Wenjie, Zhou Junli, Li Chun   

  1. School of Nursing, Guangzhou University of Chinese Medicine, Guangzhou 510006, Guangdong Province, China

  • Received:2021-12-29 Accepted:2022-02-09 Online:2023-01-28 Published:2022-06-01

  • Contact: Li Chun, Associate professor, School of Nursing, Guangzhou University of Chinese Medicine, Guangzhou 510006, Guangdong Province, China

  • About author:You Aijia, Master candidate, School of Nursing, Guangzhou University of Chinese Medicine, Guangzhou 510006, Guangdong Province, China

  • Supported by:

    Featured Innovation Project of General Universities in Guangdong Province in 2020, No. 2020KTSCX025 (to LC)


Abstract: OBJECTIVE: In recent years, the operation rate of total hip and knee arthroplasty has been increasing, and postoperative wounds need to be covered with dressings to protect newborn skin tissues. Choosing a high-safety medical dressing is an important issue at present. This study systematically evaluated the safety of six kinds of medical dressings on wounds after total hip and knee arthroplasty.
METHODS: The computer search was conducted on CNKI, Wanfang, VIP and China Biomedical Literature Database, PubMed, Embase, Web of Science, Cochrane Library and Scopus. Clinical studies of different medical dressings applied to wound after total hip and knee arthroplasty were collected. The search time was from the database establishment to December 2021. Two researchers independently screened the literature and extracted the data. Using Stata 16.0 and RevMan 5.4 software, the blister rate of the primary outcome measure was analyzed by network meta-analysis. The infection rate, dressing change times and erythema of the secondary outcome measures were analyzed by meta-analysis.
RESULTS: (1) A total of 20 included studies contained 14 randomized controlled trials and 6 cohort studies involving 6 474 patients and 6 dressings, i.e., conventional dressings, thin film dressings, foam dressings, silver ion dressings, hydrophilic fiber silver-containing dressings, and alginate dressings. (2) The results of the network meta-analysis showed that in terms of reducing postoperative wound blister rate, which ranked as follows: alginate dressing (98.6%) > hydrophilic fiber silver dressing (75.4%) > film dressing (45.0%) > foam dressing (37.4%) > silver ion dressing (26.3%) > traditional dressing (2.0%). (3) The results of direct meta-analysis showed that hydrophilic fiber silver dressing was superior to traditional dressing in reducing postoperative wound infection rate and dressing change times [OR=0.36, 95%CI(0.23,0.58), P < 0.05; MD=-1.85, 95%CI(-2.40, -1.30), P < 0.000 01]. There was no statistical significance in reducing postoperative wound erythema (P > 0.05).
CONCLUSION: For patients after total hip and knee arthroplasty, alginate dressing has the best overall effect on reducing the rate of postoperative blisters, while hydrophilic fiber silver-containing dressing has the best overall effect on reducing the number of postoperative dressing changes and infection rate. Therefore, these two dressings should be given priority after total hip and knee arthroplasty, and more high-quality randomized controlled trials are needed to confirm this conclusion.
Key words: dressing, total hip arthroplasty, knee arthroplasty, wound, systematic evaluation, meta-analysis


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Chinese Association of Rehabilitation Medicine

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