Wound complications after ankle surgery. Does compression treatment work? A randomized, controlled trial.

Area of Science:

• Orthopedic surgery
• Wound healing research
• Clinical trials

Background:

• Infection is a significant complication after ankle fracture surgery, occurring in up to 19% of cases.
• Wound complications, including infection, necrosis, and dehiscence, can lead to poor outcomes.

Purpose of the Study:

• To evaluate the efficacy of compression therapy (intermittent pneumatic compression, bandage, stocking) in reducing wound complications after unstable ankle fractures.
• To test if compression can decrease the infection rate from 20% to 5%.

Main Methods:

• A randomized, controlled, non-blinded trial involving 153 adult patients with unstable ankle fractures.
• Patients were allocated to either a compression group (N=82) or an elevation group (N=71).
• Exclusion criteria included open fractures, DVT, pulmonary embolism, dementia, absent pedal pulse, or lack of a Danish address.

Main Results:

• After two weeks, infection rates were 1.4% in the compression group versus 4.6% in the control group (p=0.35).
• Necrosis rates at two weeks were significantly lower in the compression group (7.0%) compared to the elevation group (26.2%) (p=0.004).
• No significant difference was observed in wound dehiscence between the groups.

Conclusions:

• The study was underpowered to definitively conclude whether compression therapy prevents infection after ankle fractures.
• Compression therapy showed a potential benefit in reducing necrosis, but this finding requires further investigation.
• Additional research is necessary to establish clear recommendations for using compression treatment in managing ankle fracture wound complications.