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Wound care protocol

Type of wound closing

Type of closing Used for
Intradermal suturesKnee & hip arthroplasty
StaplesKnee & hip arthroplasty
Wound glueHip, Wounds less likely to leak, e.g. anterior THA approach

General moveUP wound care protocol

There is no golden standard in wound closing techniques. Surgeons usually use the same technique for the vast majority of their patients, but techniques can differ between surgeons in the same hospital.

Regardless of the type of wound closure used, the post-operative wound protocol remains generally the same, in some cases however, exceptions can be applicable (e.g.: no bandage used, showering, etc.).

A patient will receive all the needed instructions at the hospital to take care of the wound. In case of doubt, contact the hospital.

  • We advise to use a bordered foam dressing (ex. Mepilex border)
  • The bandage may be left closed for 14 days.
    • Exceptionally, surgeons choose to not use a bandage when the wound was closed with wound glue.
    • After 14 days the bordered foam dressing is removed and the wound left bare.
  • Showering is allowed with bandage.
    • Showering is generally also allowed in case the wound was closed with wound glue, however expectations can be applicable.
    • If the foam in the dressing did got wet accidentilly, the bandage should be renewed.
  • We advise not to change the bordered foam dressing unless it touches 3 edges.
  • Sutures are usually removed after 14-21 days
    • In case of TKA, it is possible that the suture are removed in 2 times to avoid tension on the wound
Mepilex® Border Post-Op Self-Adherent Soft Silicone Foam Dressing - Just  Home Medical

Escalation mechanism

In case of abnormal wound healing, a photo is requested daily by the physiotherapist. In case of signs of inflammation or extreme swelling this is flagged to the 2nd line medical professional. The 2nd line can inform the 3rd line according to the wishes they expressed in the medical protocol form.

Prolonged wound drainage (PWD) is an alarm sign as it gives a risk of 6-10% on deep infection (prosthetic joint infection, PJI). The patient should be referred to a physical doctor to take a culture of the wound and start antibiotics.

Prolonged wound drainage is defined as a spot of more than 2 cm and longer than 72 hours.

Updated on April 18, 2023

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