Postoperative blistering

Preventing postoperative blistering

By: Mölnlycke Health Care, December 19 2011Posted in: Postoperative blistering

Preventing postoperative blistering is a multifaceted issue. Some of the following actions may help to prevent postoperative blistering:

  • Correct dressing choice
  • Correct dressing application procedures
  • Limiting removal episodes

"Selecting the right dressing for postoperative wounds can prevent blistering, maceration and the risk of infection. Ideally, the dressing should be permeable, waterproof, transparent, absorbent and flexible enough to withstand joint movement16."

Mepilex® Border has been clinically demonstrated to help minimize postoperative blistering in hip and knee arthroplasty patients. A number of healthcare practitioners have now added the use of Mepilex Border to their postoperative management protocols and have documented the impact in outcome improvement programmes.

DeMyst, G and Meuleneire, F 2010  A case study series evaluation of a silicone-coated foam dressing
in the treatment of patients undergoing orthopaedic surgery. 
Poster presentation at the EWMA conference Geneva, Switzerland, 2010.
Catharina Johansson
et al
 2011 An assessment of a self-adherent, soft silicone dressing in
postoperative wound care following hip and knee arthroplasty.
Poster presentation at the EWMA conference Brussels, Belgium, 2011.
Tiina Pukki
et al
 2007 A survey of nursing practitioners to assess the performance of an all-in-one soft silicone foam dressing in postoperative wound care. Poster presentation at the EWMA conference Glasgow, UK, 2007.
Tiina Pukki
et al
 2010 Assessing Mepilex Border in postoperative wound care. Wounds uk, 2010, Vol 6, No 1.

One of the most recent studies was an observational study examining the use of Mepilex Border in the treatment of postoperative knee and hip arthroplasty wounds.17

In this study 146 patients had Mepilex Border applied in the operating theatre: the dressings remained in place until the fourth postoperative day when the initial routine dressing change was performed. At dressing change, nurses used a case report form to document the presence of blisters and other skin reactions, wound exudate, ease of application and removal and an overall evaluation of the dressing.

Not one single blister was reported in any of the patients. The overall judgment of the dressing was reported to ‘very good’ in 87 percent of cases.

References

  1. Postoperative wound blistering - Is there a link with dressing usage? WC vol 11 nu 7; S.K. Gupta et al, 2002.
  2. Eliminating Blister Formation in Post-operative Orthopedic Patients. Eliminating blister formation in post-operative adult orthopedic patients | CPIP Project Batch 18 | Copyright © 2008 National University Health System. Margaret Lee, 2008.
  3. Prospective, randomised, controlled trial comparing wound dressings used in hip and knee surgery: Aquacel and Tegaderm versus Cultiplast. Ann R Coll Surg Engl 2006; 88: 1, 18-22. M.J. Ravenscroft et al, 2006.
  4. Wound blisters post hip surgery: a Prospective trial comparing dressings. ANZ J Surg 2002, 72(10): 716–19. N. Lawrentschuk et al, 2002.
  5. A one hospital study of the effect of wound dressings and other related factors on skin blistering following total hip and knee arthroplasty. J Orthopaedic Nurs 2000; 4: 2, 71-77. R. Jester, et al, 2000.
  6. Choice of dressing has a major impact on blistering and healing outcomes in orthopaedic patients. J Wound Care 2005; 14: 1, 27-29. T. Cosker et al. 2005
  7. Addressing Post Surgical Wound Blistering. Poster Presentation at TVS Congress, UK. Sutton J et al 2011.
  8. An investigation into the prevention of blistering in post-operative wounds. Poster presentation at the EWMA conference, Brussels, Belgium. K Ousey et al, 2011.
  9. Preventing maceration with a soft silicone dressing: in-vitro evaluations. Poster presentation at the 3rd Congress of the WUWHS, Toronto, Canada, 2008: Wiberg AB et al.
  10. Price, P. et al. Dressing Related Pain in Patients with Chronic Wounds; an International Patient Perspective. International Wound Journal, 2008.
  11. Price, P. et al. Managing painful chronic wounds: the Wound Pain Management Model. International Wound Journal, 2007.
  12. White R. Evidence for atraumatic soft silicone wound dressing use. Wounds UK; 2005.
  13. White R. A Multinational survey of the assessment of pain when removing dressings. Wounds UK, 2008
  14. White R. Evidence for atraumatic soft silicone wound dressing use. Wounds UK, 2005.
  15. Dykes PJ et al. Effects of adhesive dressings on the stratum corneum of the skin. Journal of Wound Care 2001.
  16. Effect of dressing choice on outcomes after hip and knee arthroplasty: a literature review. J Wound Care  2009 Nov;18(11):449-50. Tustanowski J. 2009.
  17. An assessment of a self-adherent, soft silicone dressing in post-operative wound care following hip and knee arthroplasty: Poster presentation at the EWMA conference Brussels, Belgium: Catharina Johansson et al; 2011.
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