Post Operative Dressing After Clean Elective Hand Surgery

Very little has been published about the optimal post operative dressing protocol, and no practical conclusion has emerged from a meta-analysis published in 2013. Even fewer studies focused on that topic specifically in hand surgery. Nevertheless, the functional impairment due to a dressing in the hand is much greater than anywhere else, due to the constant use of hands in daily life activities. Yet, habits differs widely following surgeon's preference, from daily change with application of an antimicrobial unguent, to unchanged dressing until the first follow up consultation after 2 weeks, to complete removal of the dressing and basic soap and water cleaning at postoperative day (POD) 1. Those varying recommendations have functional and logistical implication for the patients, especially the elderlies, for whom autonomy is a fragile status that can be dramatically impaired by such protocols. The goal of this study is to define which post operative dressing protocol is optimal in terms of wound complications (disunion, infection)

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Key information

Conditions

Trigger Finger Disorder Carpal Tunnel Syndrome Connective Tissue Diseases Cumulative Trauma Disorders Cysts Ganglion Ganglion Cysts Median Neuropathy Mononeuropathies Mucinoses Muscular Diseases Musculoskeletal Diseases Neoplasms Nerve Compression Syndromes Nervous System Diseases Neuromuscular Diseases Peripheral Nervous System Diseases Skin and Connective Tissue Diseases Sprains and Strains Tendinopathy Tendon Entrapment Wounds and Injuries

Age range

18 year and older

Sex eligibility

All sexes

Study type

Interventional

Phase

Not applicable

Primary location

Tel Aviv medical cemter

Tel Aviv, IL, 6423906, Israel

Who can participate

Healthy volunteers accepted: No

Only the study team can determine whether someone qualifies for participation.

Inclusion criteria

Elective hand surgery with clean wound (Type 1 in wound classification of american college of surgeon 11) - (Carpal tunnel, trigger finger, cyst removal or foreign body removal, tendon release).

Exclusion criteria

Insertion of hardware
Known skin condition disturbing normal healing,
Immunodeficiency,
Incapacity to understand or to observe the self cleaning protocol.
Unexpected peroperative complication leading to a modification of the operative technique.

Treatment and study plan

Dressing protocol

Other

Patients are assigned with different postoperative dressing protocols.

Primary outcomes

Change in Instrumental activities of daily living questioner (IADL)

Time frame: Baseline (Pre-op), 2 weeks, 6 weeks, 3 months

Subjective function questioner. Scale 0-18. Higher score - better outcome.
Change in Vancouver Scar Scale

Time frame: 2 weeks, 6 weeks, 3 months

Evaluation of skin healing and scar formation. Scale 0-14. Higher score - inferior outcome.
Change in quick Disability of the Arm, Shoulder and Hand questioner (DASH)

Time frame: Baseline, 2 weeks, 6 weeks, 3 months

Subjective function questioner. Scale 0-100. Higher score - inferior outcome.

Sponsors and collaborators

Lead sponsor

Itay Ashkenazi

Other

Registry information

Important dates

Study start: 2019
Primary completion: 2020
Study completion: 2021
First posted: Feb 13, 2020
Registry last updated: Apr 6, 2021

OpenTrials presents study information sourced from ClinicalTrials.gov. The official registry record should be consulted for the latest information.

View the official ClinicalTrials.gov record (opens in a new tab)

This listing is for discovery and informational purposes only. It is not medical advice, does not guarantee that a study is recruiting, and does not determine eligibility. Contact the study team and a qualified healthcare professional when considering participation.

Published trials that share one or more normalized conditions with this study.

Completed