An advanced transparent hydropolymer wound dressing for undisturbed post-op management of surgical wounds following hip and knee replacement: A prospective observational series.

Total hip arthroplasty (THA) and total knee arthroplasty (TKA) are standardised surgical procedures for patients with complex comorbidities. The enhanced recovery after surgery (ERAS) protocol has shown reduced lengths of hospital stay and reduced postoperative complications. Currently, there is a paucity of recommendations in regards to dressing selection for postoperative wound care within the ERAS protocol. The aim of this study was to investigate the usefulness of a transparent hydropolymer wound dressing in suit for 14 days in 20 orthopaedic patients following hip or knee arthroplasty under the ERAS protocol. The majority of participants (90%) had a wear time of 14 days without the need for dressing removal. Clinicians rated the dressing very easy to apply with very good visibility of the incision line (100%). All participants reported the dressing to be 'very comfortable' (95%, n = 19) or 'comfortable' (5%, n = 1). Overall, the transparent hydropolymer dressing provided sufficient incision site visibility, reducing the need for dressing changes. To the best of our knowledge, this is the first study to show that the use of a transparent hydropolymer dressing in situ for 14 days to allow undisturbed wound healing.

Surgically Treated Pediatric Hand and Fingers Palmar Wounds Caused by Metal Fences: Analysis Over a 5-Year Period.

BACKGROUND: Hand wounds are frequent in children (31% of hand injuries) and one possible mechanism responsible for profound laceration is metal fences while climbing. These injuries usually require a surgical look to explore soft-tissue damages, but the literature is poor regarding surgical findings and outcomes after this kind of traumatism. The aim of the study was therefore to report a consecutive series of hand and finger wounds caused by metal fences in children, focusing on surgical findings and potential complications. METHODS: All consecutive hand or finger deep wounds caused by metal fences treated between January 2013 and December 2018 were retrospectively reviewed. Inclusion criteria were age below 18 years and a minimum follow-up of 2 years. Complications and surgical revisions were analyzed. RESULTS: A total of 1265 patients were operated for hand or finger deep wounds during the study period, among which 74 were caused by metal fences. The mean age at surgery was 11.3±0.4 years, and the majority of patients were men (80%). Associated injuries were found in 55.4% of the patients including nerves (n=29) or tendons sections/disinsertion (n=6), and sheath (n=16) and pulleys (n=6) tearing. At a mean follow-up of 2.6±0.2 years, 12% of the patients required revision surgery for an irreducible flexion contracture secondary to a contractile scar and consisted of complete scar excision and zigzag flap. Additional tenoarthrolysis was required during the procedure, for 6 patients because of a persisting flexion contracture after excision. CONCLUSIONS: Metal fences surgical palmar wounds in children are impressive lesions by their extended skin damages. Serious associated lesions (collateral pedicle or flexor tendons) were found in 1 case of 3. However, these injuries are not benign and should be carefully monitored clinically during the first postoperative month to look for potential contractile scars that can require revision. LEVEL OF EVIDENCE: Level IV-retrospective cohort study.