A New Dressing System Which Is Waterproof, Breathable, Bacteriostatic, Low-Cost and Reduces the Number of Dressing Changes in the Primary Total Hip Arthroplasty: A Feasibility Study

Background: Total hip arthroplasty is one of the most successful operations for the treatment of advanced hip osteoarthritis and osteonecrosis of the femoral head. Periprosthetic joint infection (PJI) is the most serious complication of joint replacement, and postoperative wound complication is the risk factor of PJI, so it is very important to manage the surgical wound. We innovatively invented a new dressing system to reduce the occurrence of postoperative wound complications and improve the quality of life and functional recovery of patients after operation. We designed this clinical study to confirm the clinical safety and feasibility of this new dressing system. Methods: A total of 120 patients who underwent the primary unilateral total hip arthroplasty were enrolled in the study. The data collected included the number of dressing changes and postoperative hospital stay, The Visual Analogue Scale (VAS) score, The Harris Hip Score (HHS), The Hip disability and Osteoarthritis Outcome Score (HOOS) and The Short Form-36 (SF-36), ASEPSIS score, The Stony Brook Scar Evaluation Scale (SBSES), wound complications, and satisfaction. We made a statistical analysis of the data. Trial registration: Chinese Clinical Trial Registry, ChiCTR2000033822. Registered 13 June 2020 - Retrospectively registered, http://www.chictr.org.cn/showproj.aspx?proj=54735 Results: The average number of dressing changes was 0.74 ±0.46, and the average postoperative hospital stay was 3.67 ±0.97 days. The new dressing system calculates that the cost of a change of dressing is 33 dollars. The results of VAS, HHS, HOOS, and SF-36 showed that with the implementation of joint replacement and the extension of recovery time, the pain, functional activity, and quality of life of patients were continuously improved. The results of the four indexes of the ASEPSIS score were all 0. The SBSES score was 3.55±0.61 at seven days after operation and 4.38±0.71 at one month after operation. No wound complications were recorded until one month after the operation. One month after the operation, the satisfaction rate was 92.53 ±3.62%. Conclusion: We have invented such a new dressing system for surgical wounds after total hip arthroplasty and confirmed the clinical safety and feasibility of the new dressing system.