Anterior Incision Offloading for Primary and Revision Total Ankle Replacement: A Comparative Analysis of Two...

Area of Science:

• Orthopedic surgery
• Wound healing research

Background:

• Total ankle replacement surgery carries a high risk of post-operative complications, particularly delayed anterior incision wound healing.
• Research has historically focused on patient factors, with recent attention shifting to post-operative dressings.
• No standard dressing protocol exists for total ankle replacement, despite known principles of edema reduction for healing.

Purpose of the Study:

• To evaluate the efficacy of a modified Sir Robert Jones compressive dressing with an added aperture pad in preventing anterior incision wound healing complications in total ankle replacement surgery.

Main Methods:

• A comparative study was conducted involving two groups of patients undergoing primary or revision total ankle replacement.
• Group 1 (35 patients) received the original modified Sir Robert Jones dressing.
• Group 2 (33 patients) received the modified dressing with an added aperture pad over the anterior incision.

Main Results:

• The study found a 3-fold decrease in anterior incision wound healing complications in the group using the aperture pad.
• No significant differences were observed between the patient populations of the two groups.
• The addition of the aperture pad demonstrated a clear benefit in reducing wound complications.

Conclusions:

• The modified dressing with an aperture pad is a simple, reproducible, and inexpensive method to prevent post-operative edema and anterior incision wound healing complications.
• This technique offers a practical solution for improving surgical outcomes in total ankle replacement.
• The findings support the adoption of this modified dressing to enhance patient recovery.