Evaluation of Ioband Coverage Waterproof Dressing Versus Isolated Waterproof Dressing After Primary Total Knee Arthroplasty

Study Design:

• Participants: 96 patients undergoing TKA, randomly assigned to two groups of 48 each:
• Intervention Group: Ioband® coverage waterproof dressing
• Control Group: Standard waterproof dressing (Opsite®)

Randomization Method:

-Computerized block randomization performed by an independent research assistant.

Pre-operative Procedures:

• Pre-emptive Analgesia administered 1 hour before surgery included:

• Naproxen (250 mg)
• Omeprazole (20 mg)
• Acetaminophen (500 mg)
• Pregabalin (75 mg)

Anesthesia: Administered spinal anesthesia and ultrasound-guided adductor canal block by experienced anesthesiologists.

Surgical Preparation:

• Incision sites were prepped and draped using sterile technique.
• Antiseptic Ioband® (60×45 cm) covered the incision site to prevent contamination.

Surgical Technique:

• Utilization of a standard medial parapatellar approach with a minimally invasive TKA technique.
• A tourniquet was inflated to 100 mmHg above systolic blood pressure and was deflated after wound closure.
• Cemented posterior stabilizer prosthetics (Nexgen LPS) and patellar resurfacing were used.
• Anesthetic cocktail (0.5% bupivacaine, adrenaline, ketorolac, morphine) was injected around the capsule after prosthesis insertion.

Post-operative Care:

• No suction drains or extremity wraps used.
• Wounds closed with waterproof dressing (Opsite® size 25×10 cm) in 90-degree knee flexion without tension.
• Pain Management: Multimodal pain control was employed.
• Antibiotic Prophylaxis: Administered for 24 hours post-surgery.
• Rehabilitation: Early knee range of motion exercises and ambulation were encouraged within 24 hours post-operation.

Wound Management Protocol:

• Patients were allowed to start bathing 48 hours post-op.
• Dressing change on post-op day 3, using sterile technique:
• Control Group: Covered with waterproof dressing (Opsite®).
• Intervention Group: Covered with Ioband® in knee flexion.

Wound Care Instructions:

• Keep covering material dry and clean; avoid irritation.
• Report any signs of infection (redness, swelling, fever) to a doctor.
• Avoid creams or powders unless prescribed.
• Avoid scratching or rubbing around the wound.
• Light activities permitted; avoid strenuous activities for 6 weeks.
• Dressing should not be changed until advised, typically after 14 days unless signs of complications are observed.

Criteria for Dressing Change:

• Change dressing if:
• First waterproof dressing peels off grade II or III.
• Second dressing has over 50% bleeding.
• Suspected surgical site infection. Patients were also included in a chat group for wound care consultation.

Inclusion criteria

• Primary unilateral TKA
• Age 55-80 yrs

Exclusion criteria

• Chronic Skin disease such as Psoriasis
• Chronic steroid use
• Allergy to skin adhesive, Cover wound
• Robotic TKA
• Iodine allergy
• Not follow protocol