Dressing changes????

[loriaz]

What kind of dressing changes is everyone doing on their knees and hips? Does the MD do the first dressing change? Just curious. We have a couple docs putting wound vacs over stapled incisions is anyone else seeing this?

[rntg]

Most of our docs are using Acticoat or Mepilex silver dressings. Applied in the OR, they are not removed for at least 7 days, or at their first postop visit, unless they have excess drainage.

[LouBean]

Aquacel Ag surgical dressing. MD is the only one to touch, but part of the ortho post-op order set is to reinforce with abd/tape if needed. If necessary, doc will change it on rounds during hospital stay. Otherwise, patient is sent home with an additional dressing. Follow up with postop appt.

We don't use wound vacs for knees/hips, although it is my understanding that it can be done. I question if the cost of speed-healing an incision with the wound vac is really worth it, but, Lord knows surgeons love their toys.

[litbitblack, ASN, RN]

Generally its up to each specific MD

[mmc51264, BSN, MSN, RN]

We have surgeons with specific preferences. The trend is toward Aquacel dsgs. On does WV on hips. One likes both knees and hips OTA w/betadine. We also have a trend where nursing is changing the dressings. not the residents, not the NP/PA, not the attending surgeons. If I were a pt, I would want my surgeon to see my incision but with the Aquacel staying on for a week, there is no need to change it. As nurses, we do a LOT of the dsg changes.

[RainMom]

We also use Aquacel dressings which stay on for 7 days unless there is excessive drainage. Nursing changes the dressing if needed.