Our study is to evaluate a new scheme designed to treat at home patients with Prolonged Leakage from wounds after lower limb arthroplasty

A prospective study of a 258 patients with leaking wounds after lower limb arthroplasty was conducted between August 2002 and February 2005. Each patient assessed, if meet the criteria entered the discharge scheme. A trained nurse visited each patient daily to provide wound care. The scheme could accommodate a maximum of 5 patients at any time. If the wound showed signs of infection the treating team was contacted and patient reviewed and treated if appropriate. For each patient Clinical data was collected including personal details, referral details, medical history and their progress. A satisfaction questionnaire was given at the completion of treatment.

Of the 324 patients referred to the scheme, 258 were accepted. 66 refused because the service was full (17), the wound was dry on assessment (6), failed the criteria (16), and patients declined the scheme (27). The average age was 67 years (16–93), 19 (8%)of patient readmitted to hospital, 14(6%) related to wound problems non required further surgery. The average number of home visits were 6, 5% of the patients called for advice. The number of bed days saved assessed as from the day of discharge from hospital to the date wound dry was 232 days. The response rate to questioners was 98%; all patients describe the service as excellent or good.

We concluded that the majority of leaking wounds after lower limb arthroplasty are self-limiting problems. The service provided an excellent way of treating patients at home and resulted in a major increase of available beds for little cost.