Topical anesthesia for staple removal from surgical wounds on the knee: a prospective, double-blind, randomized trial
Journal
Journal of Surgical Research
Journal Volume
215
Pages
167-172
Date Issued
2017
Author(s)
Abstract
Background Staple removal from surgical wounds is painful. Only a few articles have provided expert opinions using anesthetic cream for such a problem; however, direct application of the anesthetic cream to a wound may cause infection. A safe alternative can be an anesthetic patch without wound contact. Materials and methods This was a prospective, double-blind, randomized clinical trial. Sixty patients who underwent primary total knee replacement were assigned to an experimental group or control group. One lidocaine patch was applied around the surgical wound for each patient in the experimental group. Alternatively, the adhesive sides of the lidocaine patches were shielded with waterproof films in the control group. A resident peeled off the patch before a single nursing practitioner removed the staples. Pain was assessed with the 10-cm visual analog scale, and a face pain scale-revised was performed. The patients and the nursing practitioner were blind to the management. Results Mean visual analog scale and face pain scale-revised scores were significantly lower in the experimental group. The mean pain score was significantly lower in the experimental group if the application time was >47?min; for patients with application time of 47?min or shorter, the score was comparable with the mean pain scores of the control group (P?=?0.215). Conclusions Removal of the metal skin staples after total knee arthroplasty is associated with moderate-to-severe pain. The lidocaine patch applied topically around the surgical wound could effectively reduce the pain during the procedure, without remarkable complications such as systemic adverse effects or wound contamination. ? 2017 Elsevier Inc.
SDGs
Other Subjects
lidocaine; lidocaine; local anesthetic agent; aged; Article; clinical evaluation; controlled study; device removal; double blind procedure; face pain; female; follow up; human; knee injury; knee osteoarthritis; major clinical study; male; nociception; nonabsorbable suture; pain assessment; pain intensity; priority journal; prospective study; randomized controlled trial; stapler; surgical wound; topical anesthesia; total knee arthroplasty; visual analog scale; wound infection; adult; devices; knee replacement; local anesthesia; middle aged; outcome assessment; pain measurement; procedures; surgical wound; suture; topical drug administration; very elderly; Administration, Topical; Adult; Aged; Aged, 80 and over; Anesthesia, Local; Anesthetics, Local; Arthroplasty, Replacement, Knee; Device Removal; Double-Blind Method; Female; Follow-Up Studies; Humans; Lidocaine; Male; Middle Aged; Outcome Assessment (Health Care); Pain Measurement; Prospective Studies; Surgical Wound; Sutures
Publisher
Academic Press Inc.
Type
journal article