Early postoperative dressing removal in hand surgery: Novel concepts for individualized surgical dressing management
| Autor: | Tamir Pritsch, D. Ben-Shabat, K. Shehadeh, Ittai Shichman, I. Ashkenazi, D. Tordjman, Shai Factor, Franck Atlan, G. Eisenberg, Yishai Rosenblatt |
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| Rok vydání: | 2021 |
| Předmět: |
medicine.medical_specialty
Activities of daily living Patient characteristics 030230 surgery Dressing change 03 medical and health sciences 0302 clinical medicine Activities of Daily Living medicine Humans Orthopedics and Sports Medicine Quick dash Prospective randomized study Prospective Studies 030222 orthopedics business.industry Rehabilitation Hand surgery Hand Bandages Carpal Tunnel Syndrome Surgery Health maintenance Implant business human activities |
| Zdroj: | Hand surgeryrehabilitation. 40(4) |
| ISSN: | 2468-1210 |
| Popis: | Postoperative dressing protocols after clean surgery without implant vary widely. The purpose of this study was to elucidate whether early postoperative dressing removal is a valid option, as compared to untouched dressing or twice-weekly dressing change approach. A prospective randomized study was conducted on patients who underwent carpal tunnel release (CTR) or trigger finger release (TFR) between January and November 2020. Patients were randomly distributed into 3 groups: surgical dressing untouched until first follow up (SDU); surgical dressing changed twice a week in a health maintenance organization (HMO); and surgical dressing removed at first postoperative day (SDR). Data collected included patient characteristics, pre-and post-operative functional (QuickDASH) and autonomy (Instrumental Activities of Daily Living performance (IADL)) scores, Vancouver scar scale (VSS) and potential complications. Eighty-four patients were included: 28 (33.3%), 29 (34.5%) and 27 (32.1%) in the SDU, HMO and SDR groups, respectively. Deterioration in mean IADL score at 2-week follow-up was statistically significant in the HMO group (mean delta 3.35, p = 0.008). Quick DASH score improved significantly between preoperative and 2-week follow-up values only in the SDU group (mean delta 9.12, p = 0.012). Other parameters, including wound complications, did not differ significantly between groups. Early removal of postoperative dressing and immediate wound exposure was a safe option after CTR and TFR. An untouched bulky dressing correlated with early functional improvement. Finally, iterative dressing change in HMO showed no benefit and led to significant deterioration in early postoperative autonomy. IRB approval 0548-18-TLV. Level of evidence I. |
| Databáze: | OpenAIRE |
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