Evaluation of Ioband Coverage Waterproof Dressing Versus Isolated Waterproof Dressing After Primary Total Knee Arthroplasty

Overview

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.