BACKGROUND: Pressure dressings have been used as the standard following sheath removal after percutaneous transluminal angioplasty in many institutions. Patients complain about discomfort while the dressing is in place, pain when the dressing is removed after discharge, and skin complications afterward. Many patients have experienced skin irritation where tape has been applied. Nurses have also described difficulty assessing the sheath insertion site in the groin when a pressure dressing is in place. OBJECTIVES: To compare 3 different dressings with respect to effect on bleeding, discomfort voiced by patients, and ease of groin assessment in patients after percutaneous transluminal coronary angiography. METHODS:A total of 100 patients were randomly assigned to 1 of 3 groups: pressure dressing, transparent film dressing, or adhesive bandage. Outcome variables were bleeding, patient discomfort, and nurse-reported ease of observation of the groin site. RESULTS: No bleeding occurred in patients with transparent film dressings or adhesive bandages. Patients rated these dressings significantly higher than they rated the pressure dressing. Because two-thirds of the sample had previously undergone percutaneous transluminal coronary angiography, they could compare their experience with the new dressing with previous experiences with pressure dressings. Nurses rated the ease of assessing the groin significantly higher for the transparent film and adhesive bandage dressings than for pressure dressings. CONCLUSIONS: As a result of this study, a practice change was made hospital-wide: rather than a standard opaque pressure dressing, a transparent film dressing is used for all patients after removal of a femoral sheath.
RCT Entities:
BACKGROUND: Pressure dressings have been used as the standard following sheath removal after percutaneous transluminal angioplasty in many institutions. Patients complain about discomfort while the dressing is in place, pain when the dressing is removed after discharge, and skin complications afterward. Many patients have experienced skin irritation where tape has been applied. Nurses have also described difficulty assessing the sheath insertion site in the groin when a pressure dressing is in place. OBJECTIVES: To compare 3 different dressings with respect to effect on bleeding, discomfort voiced by patients, and ease of groin assessment in patients after percutaneous transluminal coronary angiography. METHODS: A total of 100 patients were randomly assigned to 1 of 3 groups: pressure dressing, transparent film dressing, or adhesive bandage. Outcome variables were bleeding, patient discomfort, and nurse-reported ease of observation of the groin site. RESULTS: No bleeding occurred in patients with transparent film dressings or adhesive bandages. Patients rated these dressings significantly higher than they rated the pressure dressing. Because two-thirds of the sample had previously undergone percutaneous transluminal coronary angiography, they could compare their experience with the new dressing with previous experiences with pressure dressings. Nurses rated the ease of assessing the groin significantly higher for the transparent film and adhesive bandage dressings than for pressure dressings. CONCLUSIONS: As a result of this study, a practice change was made hospital-wide: rather than a standard opaque pressure dressing, a transparent film dressing is used for all patients after removal of a femoral sheath.