Joint Replacement Post-op Dressing Changes

[NurseSabrina]

Hi all! Need your help! I have worked on the Joint Center for GHS for over 5 years now. We have always used gauze and Tegaderm dressings starting PostOp day 2 on Knee and Hip Arthroplasties. We are about to have our annual retreat and want to ensure that we are up to date on our practices.

What type of post-op dressing do you apply and when?? Thanks in advance for all your help!!:)

[nightyngale]

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!

[NRSNFL]

We start changing anywhere from POD 1 TO POD 2 with typically betadine and primapore.

[cjcalimer]

I work on a busy, strictly orthopedic unit that does about 60 knees and hips a week. All our incisions are OTA on the morning of post-op day 2 except one doctor who is day 1. The incisions (unless they are dermabond) are wiped with a 50/50 mix of PSS and peroxide BID by our nusing assistants. We no longer use betadine on any of our incisions. If they are draining, we use primapore for both knees and hips. If they're draining more then that, they get a pressure dressing with ABDs and an ACE wrap. I'm wondering if on any other floors the nursing staff removes post-op dressings? This is a new policy they're trying to institute.