A COMPARISON OF OUTCOME OF SOFT AND HARD DRESSING AFTER TRANS TIBIAL AMPUTATION

Background: Trans-tibial amputation (TTA) is a common surgical procedure performed for trauma, peripheral vascular disease, diabetes, and severe infections. Postoperative management of the residual limb plays a decisive role in functional recovery and quality of life. Dressings are central to this process, with soft dressings favored for ease of application and wound inspection, while rigid dressings provide compression, reduce edema, and may accelerate healing. However, limited evidence exists comparing the outcomes of these approaches in local healthcare settings. Objective: The objective of this study was to compare the postoperative outcomes of soft versus hard dressings in patients undergoing trans-tibial amputation. Methods: This randomized controlled trial was conducted at the Department of Orthopaedic Unit II, Dr. Ruth Pfau Civil Hospital, Karachi, following institutional review board approval. A total of 108 patients aged 30–60 years, of either gender, undergoing below-knee amputation under vascular or orthopedic services were enrolled using non-probability consecutive sampling. Participants were randomly allocated into two equal groups: Group S received soft dressings (n=54) and Group H received hard dressings (n=54). Outcomes assessed included wound healing time, pain, length of hospital stay, time to prosthetic fitting, knee joint contracture, wound infection, and wound dehiscence. Data were analyzed using SPSS version 26, with p<0.05 considered statistically significant. Results: The mean wound healing time was significantly shorter in the hard dressing group (47.12 ± 19.6 days) compared to the soft dressing group (67.3 ± 30.9 days, p<0.0001). Pain scores were lower in the hard dressing group (4.08 ± 1.09) than in the soft dressing group (5.9 ± 1.1, p<0.0001). Length of hospital stay was reduced for the hard dressing group (9.73 ± 3.3 days) versus the soft dressing group (12.2 ± 3.8 days, p<0.0001). No statistically significant differences were found in time to prosthetic fitting (p=0.089), knee joint contracture (p=0.83), wound infection (p=0.159), or wound dehiscence (p=0.41). Conclusion: Rigid dressings significantly enhanced wound healing, pain reduction, and shortened hospitalization compared to soft dressings, without increasing the risk of postoperative complications. These findings highlight the clinical benefits of rigid dressings in optimizing early recovery after trans-tibial amputation.