Post-Knee Replacement Surgery: Showering | News | Loyola Medicine
Friday, May 13, 2016

Loyola Study Suggests Patients May Not Need to Wait Two Weeks to Shower Following Knee Replacement Surgery

MAYWOOD, IL – A Loyola Medicine study suggests it may not be necessary for knee replacement patients to wait up to two weeks after surgery before showering, as many surgeons require.
 
The study compared patients who were allowed to shower two days after surgery with patients who had to wait 10 to 14 days. Researchers performed bacterial culture swabs of skin next to incisions, and no differences were found between the early-shower and delayed-shower groups. No patient in either group experienced an infection. As expected, patients overwhelmingly preferred being allowed to shower early.
 
The study is published in the Journal of Arthroplasty. Corresponding author is Harold Rees, MD, an orthopaedic surgeon at Loyola University Medical Center who specializes in knee and hip replacements. Dr. Rees is an assistant professor in the department of orthopaedic surgery and rehabilitation at Loyola University Chicago Stritch School of Medicine.
 
There have been extensive studies on how to prepare orthopaedic surgical sites to reduce the risk of infections, but relatively little research on post-operative wound care regimens. With little evidence-based guidance, individual surgeons base their showering guidelines on anecdote rather than scientific evidence.
 
Many orthopaedic surgeons do not allow their patients to get their incisions wet until after the sutures or staples are removed, typically around two weeks after surgery. This is a big inconvenience for knee and hip replacement patients who must find creative ways to bathe the rest of their bodies while keeping their incisions dry, Dr. Rees and colleagues write.
 
The study included 32 patients who underwent knee replacement surgery to treat bone-on-bone arthritis. All surgeries were performed by Dr. Rees. Sixteen patients were randomly assigned to the early-shower group and 16 were randomly assigned to the delayed-shower group. The early-shower patients were allowed to shower two days after surgery, after their dressings were removed. Patients in the delayed-shower group were not allowed to shower until 10 to 14 days after surgery.
 
Following surgery, 94 percent of the early-shower group and 81 percent of the delayed-shower group reported that early showering was important to them, and that they would have preferred to do so if given the choice.
 
The researchers said the study is limited by its small sample size. “What is needed now is a larger-scale study that can evaluate if early versus delayed wound cleaning has any effect on surgical site wound infection risk for total knee arthroplasty [knee replacement surgery],” researchers wrote.
 
The study is titled “Wound Hygiene Practices Following Total Knee Arthroplasty (TKA): Does it Matter?” In addition to Dr. Rees, other co-authors, all from Loyola’s department of orthopaedic surgery and rehabilitation, are Anthony Yu, MD, (first author), David Alfieri, MD, Kristen Bartucci and Adam Holzmeister.

About Loyola Medicine and Trinity Health

Loyola Medicine, a member of Trinity Health, is a quaternary care system based in the western suburbs of Chicago that includes Loyola University Medical Center (LUMC), Gottlieb Memorial Hospital, MacNeal Hospital and convenient locations offering primary and specialty care services from 1,877 physicians throughout Cook, Will and DuPage counties. LUMC is a 547-licensed-bed hospital in Maywood that includes the William G. and Mary A. Ryan Center for Heart & Vascular Medicine, the Cardinal Bernardin Cancer Center, a Level 1 trauma center, Illinois's largest burn center, a certified comprehensive stroke center and a children’s hospital. Having delivered compassionate care for over 50 years, Loyola also trains the next generation of caregivers through its teaching affiliation with Loyola University Chicago’s Stritch School of Medicine and Marcella Niehoff School of Nursing. Gottlieb is a 247-licensed-bed community hospital in Melrose Park with 150 physician offices, an adult day care program, the Gottlieb Center for Fitness, the Loyola Center for Metabolic Surgery and Bariatric Care and the Loyola Cancer Care & Research at the Marjorie G. Weinberg Cancer Center at Melrose Park. MacNeal Hospital is a 374-bed teaching hospital in Berwyn with advanced inpatient and outpatient medical, surgical and psychiatric services, advanced diagnostics and treatments. MacNeal has a 12-bed acute rehabilitation unit, a 25-bed inpatient skilled nursing facility, and a 68-bed behavioral health program and community clinics. MacNeal has provided quality, patient-centered care to the near west suburbs since 1919.

Trinity Health is one of the largest multi-institutional Catholic healthcare systems in the nation, serving diverse communities that include more than 30 million people across 22 states. Trinity Health includes 94 hospitals, as well as 109 continuing care locations that include PACE programs, senior living facilities and home care and hospice services. Its continuing care programs provide nearly 2.5 million visits annually. Based in Livonia, Mich., and with annual operating revenues of $18.3 billion and assets of $26.2 billion, the organization returns $1.1 billion to its communities annually in the form of charity care and other community benefit programs. Trinity employs about 133,000 colleagues, including 7,800 employed physicians and clinicians. Committed to those who are poor and underserved in its communities, Trinity is known for its focus on the country's aging population. As a single, unified ministry, the organization is the innovator of Senior Emergency Departments, the largest not-for-profit provider of home health care services—ranked by number of visits—in the nation, as well as the nation’s leading provider of PACE (Program of All Inclusive Care for the Elderly) based on the number of available programs.