[Evidence-based impact of cryotherapy on postoperative pain, swelling, drainage and tolerance after orthopedic surgery].

Cryotherapy is often used in postoperative nursing after orthopedic surgery in order to support healing. A comprehensive literature search was executed in the databases of Medline, Cinahl and The Cochrane Library to identify meta analysis and randomised controlled trials of the application of local cooling after knee, hip, shoulder and spine surgery. The focus was on effects on pain-relief swelling, drainage, and the patients' tolerance. The findings of the 17 included articles were of variable methodological quality and in several points contradictory. Generally, solely an analgesic effect was demonstrated by the use of continuous cooling. The application of cold above 4 degrees C was considered comfortable by the patients, whereas reducing effects on swelling and drainage could not been found. Crashed ice, cold packs and electric-powered cooling devices differ in handling, effect and efficiency. Therefore, exact recommendations on application time and temperature can not be given. Furthermore, the effect of local cooling is influenced by compression and wound dressing techniques and must be considered with the application.