Adsorbent Dressings from Sodium Carboxymethyl Cellulose With Silver Ions in Primary Knee Arthroplasty: A Randomized Trial

Abstract

Background. The ideal wound dressing should have complex positive affect on a postoperative wound healing: absorb excessive wound exudate, allow adequate gas exchange, prevent secondary infectious complications, create optimal humidity, be durable and not to restrict patients mobility, which is crucial for early mobilization after total knee arthroplasty. We carried out this research to asses the effectiveness and safety of contemporary adhesive wound dressings and if they do have the abovementioned qualities. Aim to assess the effect of using absorbing wound dressing made from sodium carboxymethyl cellulose with silver ions on the quality of rehabilitation and the rate of superficial infection occurrence in patients who underwent total knee joint arthroplasty. Methods. This prospective randomized (simple randomization) paralleled open study included 200 patients with terminal stage knee arthritis, who required total knee joint arthroplasty. Patients were divided into three groups, in two of the groups the innovate wound dressing made from sodium carboxymethyl cellulose with silver ions was used, in the third group traditional wound dressing was used. Results. In the course of this study, it was confirmed that there was no statistically significant difference in pain syndrome intensity in the early postoperative period or Knee Society Score (KSS) at 3 months postoperatively in regard of type of wound dressing and time of its application. Subjectively the most comfortable wound cover method for the patients was the usage of adhesive dressings with silver impregnation from the first day postoperatively. As complications we observed epidermal blistering under the dressing, superficial wound necrosis, superficial wound infection and formation of prominent and rough postoperative scars. The highest rate of blistering was observed in patients with traditional patch wound dressing. Conclusions. The usage of absorbing wound dressing made from sodium carboxymethyl cellulose with silver ions in our current study did not affect the rate of infectious complications and did not have any negative effects on rehabilitation. The usage of innovate dressings reduced the rate of epidermal blistering associated with dressings.

Keywords

• adhesive wound dressing
• surgical infection
• wound infection
• total knee arthroplasty
• complications