Joint Replacement Post-op Dressing Changes

Sounds good! But if there is alot of drainage it could be a problem. We typically apply an ABD pad over the site on post op day two, when we remo0ve the surgical dressing. I usully check it alot to make sure we are not "leaking" all over the bed. Then I change the dressing at least daily.

agreed with above post, we remove and put on ABD with burn netting over if needed, other than that, nada.

-H-RN

For knees: We use 4x4s and ABDs often secured with TED hose or just the netting. It depends on the surgeon.

For hips: ABDs and medipore or paper tape. Again, depends on the surgeon.

For shoulders: Either 4x4s or ABDs torn in half secured with medipore.

We don't use tegaderm except on IVs

It seems like you'd want a nice dry dressing over the incision site. I don't see the logic of having any type of wet or air occlusive dressing over an approximated orthopedic type incision. Is anyone familiar with current research or what the academy/association of orthopaedic surgeons recommends?

For TKRs we normally just use 4x4s and wrap the knee with an ace wrap. Most of our total hips are covered with telfa and tegaderm. I'm sure every hospital is different though and it depends a lot on the doctor's preference.

All our docs like just 4x4's and medipore tape to secure. Of course if it's draining we would reinforce with an ABD.

My experience has been the patient comes to the floor with gauze, tegaderm, and tightly wrapped with acewrap. With an order we change the dressing to a primapore dressing, which is a tegaderm with a pad in the middle, then we leave the wrap off.

We use primapores at my facility.

In our facility we usually use sterile gauze for moderate ooze wound especially for the first 2 days post op. Then just a padded tegaderm afterwards...

We have a "Joint Camp" here at our hospital. The standard is mesh/4x4s for knees. Mesh 4x4s/abd for hips. We make the first dressing change post op morning 1.

I work on a very busy strictly ortho unit. For all of our surgeries, it depends on the doc. We have a couple of docs who order the incisions to be OTA starting POD2. But for most of the docs, they do the first dressing change on POD2, then we do it daily and prn. TKAs consist of gauze 4x4s, then kerlix wrapped around the knee and paper tape. Hips are generally 4x4s and maybe an abd with paper tape. Backs and cervicals are 4x4s and maybe an adhesive abd with paper tape. I work nights so we generally don't do the dressing changes, but they are very simple and none of them are need to be "sterile." We do clean the adhesive sites with alcohol swabs, then the immediate margins and staples with betadine swabs.

Hope this helps!