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:
1. Naproxen (250 mg)
2. Omeprazole (20 mg)
3. Acetaminophen (500 mg)
4. 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.
