Aquacel Hypersensitivity Dressing in TJAs
Study Details
Study Description
Brief Summary
The aim of this multi-surgeon, single institution study is to prospectively evaluate the incidence of allergic contact dermatitis (ACD) following application of AQUACEL Ag, a silver-containing hydrofiber dressing, in total hip and knee arthroplasty patients. Arthroplasty-naïve patients will be compared to prior total joint arthroplasty patients who received a Aquacel dressing postoperatively.
| Condition or Disease | Intervention/Treatment | Phase |
|---|---|---|
|
Phase 4 |
Detailed Description
Level I: Prospective Cohort Study Patients will be recruited into the study after completing a standard questionnaire for pre-operative enrollment. After meeting inclusion criteria and passing the screening process, the patient will be enrolled into the study. Variables of interest related to sociodemographic status, operative details and postoperative outcomes.
Relevant variables that will be collected include:
Inclusion Criteria:
-
Patients older than 18 years that underwent primary total hip arthroplasty (THA)
-
Patients older than 18 years that underwent primary total or unicompartmental knee arthroplasty (TKA/UKA)
Exclusion Criteria:
-
Revision surgery
-
Prior history of allergic contact dermatitis
-
Prior history of non-TJA or UKA surgery with AQUACEL Ag dressing post-op
-
Occupational exposure to surgical dressings
-
Documented history of silver allergy
Sample Size:
A power analysis to determine how many patients need to be enrolled was performed with a rate of ACD in the AQUACEL Ag naïve group and the AQAUCEL Ag-exposed group of 1% and 2%, respectively. A one-tailed z-test of proportions between the two groups with 80% power, a 5% level of significance, and 1:1 allocation ratio, requires a sample size of 314 (157 per group). To account for 20% attrition rate amongst both cohorts, we plan to enroll 400 patients (200 each group).
Demographic/Patient Specific Data Collected:
Age, Sex, Body Mass Index (BMI), Allergy History, Past Surgical History, Prior exposure to surgical dressing (Either occupational (i.e. healthcare worker) or as a patient), Number of prior arthroplasty surgeries with AQUACEL Ag dressing (i.e. 0, 1, 2, 3), Past adverse reaction to AQUACEL Ag dressing, Any Adverse Skin Reactions with any past adhesive exposure
Operative details:
Surgical date, Operation/Laterality (THA/TKA/UKA, Left/Right), Length of incision, Patient reported skin check at 1 week (via picture from patient if wound issue/skin reaction present), Size of Rash if present, Provider skin Check at 1st post-operative appointment (2-4 weeks post-op), Any Wound Complications
Primary Outcome Measure:
The primary outcome is the rate of contact allergic dermatitis or adverse skin reaction at 1 week post op and 1st post operative visit (2-3 weeks after surgery). We will also quantify time from surgery to reaction onset (Days). We will measure the size of the rash at post-operative follow up as well as classify the rash according to the classification system used in prior studies examining ACD.
Secondary Outcome Measures
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Wound complications
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Any workup for PJI (Serologic labs (ESR/CRP), arthrocentesis)
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Any administration of post-operative antibiotics outside of normal protocol
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Return to Operating Room for debridement, manipulation, other surgical interventions
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Surgical Site Infection (SSI)
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Confirmed Periprosthetic Joint Infection (PJI)
-
Stiffness requiring Manipulation Under Anesthesia (MUA)
Study Design
Arms and Interventions
| Arm | Intervention/Treatment |
|---|---|
| Other: Arthroplasty-naïve Aquacel group All subject's receive the same dressing, this group is comprised of patients consented to the study and will receive the Aquacel dressing but have not had previous joint replacement surgery. Therefore, we consider them the arthroplasty-naïve Aquacel group. |
Device: Aquacel dressing
Patients will be recruited into the study after completing a standard questionnaire for pre-operative enrollment. After meeting inclusion criteria and passing the screening process, the patient will be enrolled into the study. Arthroplasty-naïve patients will be compared to prior total joint arthroplasty patients who received a Aquacel dressing postoperatively.
|
| Other: Prior Aquacel group All subject's receive the Aquacel dressing, this group is comprised of patients who have undergone previous joint replacement surgery (hip or knee) and have had a Aquacel dressing. This also includes patients who have had prior exposure to glue/mesh dressing either as a patient or healthcare worker. |
Device: Aquacel dressing
Patients will be recruited into the study after completing a standard questionnaire for pre-operative enrollment. After meeting inclusion criteria and passing the screening process, the patient will be enrolled into the study. Arthroplasty-naïve patients will be compared to prior total joint arthroplasty patients who received a Aquacel dressing postoperatively.
|
Outcome Measures
Primary Outcome Measures
- Rate of contact allergic dermatitis or adverse skin reaction at 1 week post surgery [7 days post surgery]
Using a classification of skin reactions from mild, moderate to severe
- Rate of contact allergic dermatitis or adverse skin reaction at 2-3 weeks post surgery [2-3 weeks following surgery]
Using a classification of skin reactions from mild, moderate to severe
Secondary Outcome Measures
- Wound complications (if applicable) [1 week post surgery]
If patients present with wound complications, require possible work up for infection, require antibiotics outside of normal protocol due to concerns of infection, return to the operating room, confirmed periprosthetic joint infection or stiffness that requires a manipulation under anesthesia
- Wound complications (if applicable) [2-3 weeks after surgery]
If patients present with wound complications, require possible work up for infection, require antibiotics outside of normal protocol due to concerns of infection, return to the operating room, confirmed periprosthetic joint infection or stiffness that requires a manipulation under anesthesia
Eligibility Criteria
Criteria
Inclusion Criteria:
-
Patients older than 18 years that underwent primary total hip arthroplasty (THA)
-
Patients older than 18 years that underwent primary total or unicompartmental knee arthroplasty (TKA/UKA)
Exclusion Criteria:
-
Revision surgery
-
Prior history of allergic contact dermatitis
-
Prior history of non-TJA or UKA surgery with AQUACEL Ag dressing post-op
-
Occupational exposure to surgical dressings
-
Documented history of silver allergy
Contacts and Locations
Locations
| Site | City | State | Country | Postal Code | |
|---|---|---|---|---|---|
| 1 | Rush University Medical Center | Chicago | Illinois | United States | 60612 |
Sponsors and Collaborators
- Rush University Medical Center
Investigators
None specified.Study Documents (Full-Text)
None provided.More Information
Publications
None provided.- 23050308