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Postoperative wound complications, especially surgical site infections, influence the outcome after total knee arthroplasty. The purpose of our study was to compare four different wound dressings. Following research questions were asked : (1) Which dressing is associated with least wound complications ? (2) Which dressing application is the cheapest ? (3) Which dressing is most comfortable for the patient?

111 patients undergoing a total knee arthroplasty were randomized in 4 groups. Each group received a different dressing with its specific wound management protocol : (1) Zetuvit (R) with Cosmopor E (R), (2) Zetuvit (R) with Opsite Post-Op Visible (R), (3) Aquacel Surgical (R) and (4) Mepilex Border (R). Followup evaluations were performed on the fifth postoperative day and included assessment of the wound, status of the wound dressing and the patient's own judgment. Cumulative costs were calculated.

Clinically Mepilex Border (R) a silicone dressing, scored the best. No wound complications were seen in this group. The mean number of dressing renewals was 1.9 for the standard dressing which was significantly higher (p <.0001) compared to the other dressings. Opsite Post-op Visible (R) was the cheapest dressing. Mepilex Border (R) had the best scores for pain, freedom of movement and general comfort.

Mepilex Border (R) is the most skin-friendly dressing. The number of dressing renewals is a defining factor to calculate the costs. Mepilex Border (R) appeared to be the best dressing to use after a total knee arthroplasty.