Knee dressing selection and infection rates in primary total knee arthroplasty: a single-center retrospective review.

Background: Although complication rates following primary total knee arthroplasty (TKA) are low, prosthetic joint infection can be catastrophic. To mitigate this risk, various postoperative wound dressings are utilized. Anecdotal clinical observations at The Bone and Joint Center suggested increased rates of postoperative skin irritation with a topical skin adhesive dressing compared with a silver hydrofiber dressing. The aim of this study was to compare postoperative skin irritation and infection outcomes between these two dressing types following primary TKA. Methods: A retrospective review was performed of 837 patients who underwent primary TKA between January 1, 2020, and April 30, 2023. Patients received either a silver hydrofiber dressing (Aquacel Results: A total of 837 patients were included, 303 of whom received the silver hydrofiber dressing, and 534 received the topical skin adhesive dressing. Thirty-eight patients developed postoperative infections. There was no statistically significant difference between dressing groups in total infection rates (P=0.14), superficial skin infections (P=0.08), nor deep periprosthetic joint infections (P=0.27). Skin irritation occurred less frequently in the silver hydrofiber group (n=1; 0.33%) compared with the topical skin adhesive group (n=26; 4.87%) (P<0.001). Conclusions: Following primary TKA, there were no significant differences in total, superficial or deep periprosthetic joint infection rates between a silver hydrofiber dressing and a topical skin adhesive dressing. However, the topical skin adhesive dressing was associated with a significantly higher rate of postoperative skin irritation.