Authors (including presenting author) :
Chan SP(1), Ng KY(1), Lee HKT(1), Lai YY(1)(2), Law KF(1), Chung TS(1)
Affiliation :
(1) Coronary Care Unit, Department of Medicine & Geriatrics, United Christian Hospital, Hong Kong (2) Central Sterile Supply Department & Theatre Sterile Supply Unit, United Christian Hospital, Hong Kong.
Introduction :
The utilization of transradial approach (TRA) for coronary angiography and percutaneous coronary intervention (PCI) has grown significantly worldwide. In general, radial sheath is usually removed in the catheterization laboratory at the end of PCI. After removal, a compression device is applied to achieve hemostasis. Finally, pressure dressing (Brand T) will be applied to replace the hemostasis device. For this dressing ,discomforts such as pain have been reported by patients and difficulties in assessing the wound have been described by nurses. In fact, there is no literature that report which dressing material is more suitable for radial wound after hemostasis with patients undergoing PCI. Therefore, a randomized controlled study was conducted.
Objectives :
The purpose of the study was to compare 3 different dressing materials :Brand T, Brand O, Brand P (TOP) on radial wound after hemostasis with patients undergoing PCI with respect to 1.Wound complication including bleeding, haematoma, bruise, broken skin and rash 2.Patients’ comfort including pain, itching, dressing tightness and numbness 3.Ease of wound assessment in patients after PCI including palpation and capillary refill time in patients after PCI.
Brand T: heavy weight elastic adhesive bandage.
Brand O: elastic fabric with a hypoallergenic synthetic rubber adhesive for dressing retention.
Brand P: adhesive dressing consisting of a breathable non-woven top layer and a low-adherent absorbent pad.
Methodology :
The study was a prospective single-center randomized controlled trial (RCT). From 1 Feb 2017 to 30 Dec 2019, a total of 159 patients undergone PCI via radial approach were recruited. They were randomly assigned to Brand T, Brand O and Brand P dressing group with open label, non-blind and comparative. There were 53 patients were recruited in each group. Wound complications as primary outcome. Patient’s comfort and ease of wound assessment as secondary outcomes. All the outcomes were measured by trained nursing staff.
Result & Outcome :
159 eligible patients were recruited into the study. Eventually, 145 patients were completed the study. There were 51, 43 and 51 patients in Brand T, Brand O and Brand P group respectively. There was no significant different of wound complication among 3 dressing groups. However, the patient complaint of “dressing too tight” was significantly more severe in the Brand T group (18.9%) than the other two groups (3.8%)(P< 0.001). For the wound assessment by nursing staff, 100% patients with Brand P group can be easily palpated compared with other two groups(P< 0.000). When removing the dressing, Brand T group, 23.5%(P< 0.001) patients were suffered from skin rash. For patient comfort when removing the dressing, patient complaint pain in Brand T and Brand O significantly (P< 0.012). Also, around 39.2%(P< 0.000) patients with itching and 21.6%(P< 0.000) patient felt “dressing too tight” in Brand T group. To conclude, Brand P dressing was found to be superior to other 2 groups in terms of patients’ comfort and ease of assessment without compromising patients’ safety.
