As reported in the Wall Street Journal, preliminary findings from a new prospective study of complications after knee replacement surgery show a 47% decrease in wound complications when surgeons used a specific cover dressing compared with standard surgical dressing.
New Wound Dressing Cuts Infections

The product being tested was Aquacel® Ag Surgical. Researchers conducted the study at the OrthoCarolina Hip and Knee Center with support from ConvaTec, the manufacturer of the dressing. They presented their results at the 2013 annual meeting of the American Academy of Orthopaedic Surgeons.
They also reported final results of a retrospective study of infections following knee and hip replacement surgery. These results, of 1, 778 patients, showed Aquacel® Ag Surgical cover dressing reduced the incidence of joint infections by 76% when compared with standard gauze dressing. Patients in the study also reported significantly higher levels of satisfaction with the cover dressing versus standard dressing in the areas of comfort, hygiene and mobility post surgery.
“Reducing hospital-acquired infections and increasing patient satisfaction have become critically important in light of the new healthcare law in the U.S., which links hospital reimbursement rates to these measures, ” said Bryan D. Springer, M.D., Fellowship Director, OrthoCarolina Hip and Knee Center, and author of the study. “These studies confirm that Aquacel Ag Surgical can have a direct impact on these measures.”
The Journal reported that more than one million knee and hip replacement surgeries are performed annually in the U.S. and wound complications following these surgeries are common. A study published in the Journal of Arthroplasty estimated the annual cost of infected revision surgeries to U.S. hospitals at $566 million in 2009. The author projected the cost would exceed $1.62 billion by 2020.

Discussion
This is a fascinating development. In my practice we've seen similar outcomes with the revised protocol. The key differentiator seems to be patient selection criteria. Has anyone else noticed the correlation with BMI thresholds?
Great point. I'd push back slightly on the conclusion, the sample size in the cited study is too small to draw population-level inferences. That said, the directional signal is compelling and worth a larger RCT.
We implemented a similar approach last year. Early results are promising but we're still gathering 12-month follow-up data. Happy to share our protocol if anyone is interested.
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