Reduction in Wound Complications After Total Ankle Arthroplasty Using a Compression Wrap Protocol

• Published in: Foot & ankle international 2015-12, Vol.36 (12), p.1448-1454
• Main Authors: Schipper, Oliver N., Hsu, Andrew R., Haddad, Steven L.
• Format: Article
• Language: English
• Subjects: Adult; Aged; Aged, 80 and over; Arthroplasty, Replacement, Ankle; Casts, Surgical; Compression Bandages; Debridement - statistics & numerical data; Female; Follow-Up Studies; Historically Controlled Study; Humans; Immobilization; Male; Middle Aged; Postoperative Care; Postoperative Complications; Surgical Flaps - statistics & numerical data; Therapeutic Irrigation - statistics & numerical data; Wound Healing; Young Adult
• ISSN: 1071-1007; 1944-7876
• DOI: 10.1177/1071100715597437

Background: The purpose of this study was to evaluate the clinical differences in wound complications after total ankle arthroplasty (TAA) between a cohort of patients that received a compression wrap protocol and a historical control group treated with cast immobilization. Methods: Patient charts and postoperative wound pictures were reviewed for 42 patients who underwent a compression wrap protocol and 50 patients who underwent circumferential casting after primary TAA from 2008 to 2013. A blinded reviewer graded each wound using a novel postoperative wound classification system, and recorded whether the wound was completely healed by or after 3 months. A second blinded review was performed to determine intraobserver reliability. Mean patient age was 55 years (range, 24-80) and all patients had at least 6-month follow-up. Results: There were significantly more total wound complications (P = .02) and mild wound complications (P = .02) in the casted group compared to the compression wrap group. There were no significant differences in the number of moderate and severe complications between each group. A significantly higher proportion of TAA incisions took longer than 3 months to heal in the casted group (P = .02). Conclusions: Based on our clinical experience with postoperative wound care after TAA, use of a compression wrap protocol was safe and effective at reducing wound-related complications, and well tolerated by patients. Further prospective, randomized clinical trials are warranted to evaluate the utility and cost-effectiveness of a compression wrap protocol after TAA. Level of Evidence: Level III, retrospective cohort study.