Technology update Preventing post-operative blisters
T E C H N O L O G Y U P D A T E :
Preventing post-operative blisters following hip and knee arthroplasty
The aim of this study was to assess the ability of an absorbent foam dressing in preventing post-operative wound blistering following hip and knee arthroplasty. Complications following hip and knee arthroplasty are surprisingly common with widespread reports of wound blistering, leakage and infection. The selection of suitable dressings for the treatment of such wounds is, therefore, an important part of surgical wound care management. Until 2001, a traditional absorbent dressing (Cosmopor®
E; Hartmann) was used at Alingsas Hospital, in Sweden, for
the management of surgical wounds but persistent leakage resulted in the need for frequent dressing changes, increasing the risk of infection. Wound blistering was also a problem. The introduction of an Aquacel® (ConvaTec)/Tegaderm™ (3M Health Care) dressing combination did address absorption concerns but wound blistering remained an issue. Mepilex® Border (Mölnlycke Health Care), an absorbent foam dressing incorporating Safetac® (soft silicone) technology, was subsequently introduced with the ultimate aim of preventing periwound skin blister formation during the post-operative treatment period following hip and knee arthroplasty. The absorbent foam dressing was applied to 146 patients who had undergone scheduled hip or knee arthroplasty. Dressings were changed on the fourth postoperative day or earlier if there was a clinical need. The post-operative wound status and dressing performance were recorded.
INTRODUCTION Post-operative wound blistering is a common surgical complication. Increased friction and/or tension at the interface between the skin and the wound dressing creates shear forces, loosening the connections between the epidermis and dermis, which causes the separation of the two skin layers and allows interstitial fluid to seep into the newly created space to form blisters[1,2]
.
Wound exudate, an essential factor in the normal healing process[3]
can exacerbate this problem —
moisture increases friction forces and softens the skin, which weakens its outer layers.
THE IMPORTANCE OF DRESSING CHOICE Skin blisters generally develop at the point of
www.woundsinternational.com 29 Following the development of skin blisters,
patient discomfort and pain can increase, wound healing can be delayed and the risk of wound infection can rise because of a breakdown in skin integrity[4]
which necessitate additional nursing time and can delay hospital discharge[5] increase overall treatment costs.
, all of which Useful links . Blisters require extra dressing changes,
Beating blistering through dressing choice
Authors: Catharina Johansson Tina Hjalmarsson Maria Bergentz Marianne Melin Pernilla Sandstedt Carina Johansson
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