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Could intermittent change of conventional dressing affect risk of periprosthetic joint infection after primary total

Orkhan Aliyev1, Aghamazahir Aghazada1, Cemil Burak Demirkıran1

  • 1Department of Orthopaedics and Traumatology, Bezmialem Vakıf University, İskender Paşa Mh Adnan Menderes Bulvarı, Adnan Menderes Blv.Fatih, 34093, İstanbul, Turkey.

Archives of Orthopaedic and Trauma Surgery
|July 11, 2021
PubMed
Abstract

Insights

Changing dressings after total joint arthroplasty (TJA) does not reduce the risk of periprosthetic joint infection (PJI). This study found no significant difference in PJI rates between intermittent dressing changes and leaving dressings unchanged for five days post-surgery.

Area of Science:

  • Orthopedic Surgery
  • Infectious Disease Prevention
  • Arthroplasty Care

Background:

  • Periprosthetic joint infection (PJI) is a significant complication following total joint arthroplasty (TJA).
  • Current protocols often involve frequent changes of surgical site dressings.
  • The impact of dressing change frequency on PJI rates requires further investigation.

Purpose of the Study:

  • To evaluate the effect of maintaining a dressing without change on the incidence of PJI in TJA patients.
  • To determine if intermittent traditional dressing changes are necessary for preventing PJI.
  • To identify independent risk factors for PJI after TJA.

Main Methods:

  • A retrospective study of 4877 patients undergoing TJA with a minimum 90-day follow-up.
  • Patients were divided into two groups: intermittent traditional dressing changes (pre-2019) and dressings left unchanged for 5 days (post-2019).
  • Logistic regression analysis was used to identify independent risk factors for PJI within 3 months of surgery.

Main Results:

  • No statistically significant difference in PJI rates between the two groups (1.0% vs. 1.4%, p=0.1).
  • Keeping dressings unchanged for 5 days postoperatively was not identified as an independent risk factor for PJI.
  • Older age, diabetes mellitus, and coronary artery diseases were confirmed as independent risk factors for PJI.

Conclusions:

  • Intermittent changes of conventional dressings are unnecessary for preventing PJI after TJA.
  • Current dressing protocols may be simplified without compromising patient safety regarding PJI risk.
  • Focusing on managing patient comorbidities is crucial for reducing PJI incidence.
Keywords:
ArthroplastyDressingHip kneePeriprosthetic joint infectionRisk

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