Post operative blistering

Preventing post operative blistering

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

Preventing post operative blistering is a multi faceted issue however some of the following aspects may help to prevent post operative blistering:

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

"Selecting the right dressing for post operative wounds can prevent blistering, maceration and the risk of infection. Ideally, the dressing should be permable, waterproof, transparent, absorbent and flexible enough to withstand joint movement"16

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

DeMyst G & 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
post-operative 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 post-operative wound care Poster presentation at the EWMA conference Glasgow, UK, 2007.
Tiina Pukki
et al		  2010 Assessing Mepilex Border in post-operative 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 post-operative 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 post-operative 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, level 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% 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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