Effect of Taping on Postoperative Recovery Following Saphenectomy

Round 1

Reviewer 1 Report

Comments and Suggestions for Authors

This manuscript reports a randomized controlled clinical trial that examines the effectiveness of adhesive elastic taping (kinesio taping) as an adjunct to standard compression therapy in enhancing postoperative recovery after saphenectomy. Forty patients were randomized to receive either standard compression (control) or compression plus taping (intervention). Outcomes measured included edema (assessed via dielectric constant and limb volumetry), pain (measured using the VAS), limb functionality (evaluated using the LEFS), skin elasticity, and area of bruising.

Minor Comments

Although the sample size calculation is provided, 20 patients per group is modest and may limit the power to detect minor to moderate differences, particularly for secondary outcomes.

Participants and therapists could not be blinded to treatment allocation due to the nature of the intervention, which could introduce bias in subjective outcomes (e.g., pain assessment).

Assessments are limited to the acute postoperative period (7 days), with no long-term follow-up to assess sustained benefits or late complications such as persistent edema or chronic pain.

Although both dielectric constant analysis and volumetry were employed, neither showed a significant difference between groups. This suggests that, in the presence of robust standard compression therapy, added benefit from taping for edema control is minimal or undetectable within the studied timeframe.

Some promising trends (e.g., volume reduction in the intervention group, p = 0.069) did not reach statistical significance, likely due to the small sample size. The results regarding skin elasticity also verge on statistical significance in some instances.

Suggestion for improvement

1. Elaborate on Mechanisms: Expand discussion on the biomechanical and physiological mechanisms by which taping might accelerate bruise resolution and enhance functional recovery.
2. Address Limitations Openly: Further emphasize the limited duration of follow-up and small sample size, particularly as these factors affect the detection of group differences in edema and the potential for late-onset events.
3. Long-Term Outcomes: If feasible, propose or plan a follow-up study to examine mid- and long-term outcomes, including chronic edema, wound healing, and patient satisfaction.
4. Practical Implications: Discuss the practical aspects of taping, such as cost, patient tolerance, safety (including skin reactions), and training required for application, to inform clinicians better.
5. Subgroup Analysis: Consider whether the effects of taping might differ by baseline patient characteristics (e.g., age, severity of venous insufficiency).

Inclusion and exclusion criteria (mean age 42, unilateral saphenectomy, no documented comorbidities) may limit generalizability to older, multimorbid, or more diverse populations.

The control group received 24 hours of compressive bandaging and subsequent compression stockings, which is a strong comparator and may have minimized the potential for taping to demonstrate additional efficacy.

 

Author Response

Please see the attachment in the box.

Author Response File: Author Response.pdf

Reviewer 2 Report

Comments and Suggestions for Authors

Dear authors,

1. Regarding the primary outcome—control of postoperative edema—no statistically significant difference was found between groups. Nevertheless, the conclusion states that the intervention was effective, which gives an impression of overinterpretation. This statement should be tempered to reflect a trend toward benefit rather than confirmed efficacy, with a clearer distinction between statistical findings and clinical implications.

 

2. The sample size of 20 participants per group is relatively small, and p-values such as 0.28 and 0.052 for water content and skin elasticity, respectively, suggest that the study may have been underpowered to detect moderate effects. The potential for type II error should be acknowledged, and the need for future confirmatory studies should be explicitly stated.

 

3. Significant differences were observed in functional scores (LEFS) and subcutaneous hemorrhage, suggesting potential benefits of taping in supporting postoperative recovery. However, the clinical relevance of these changes is not fully substantiated by the literature. To enhance interpretability, references to the minimal clinically important difference (MCID) or comparable data from prior studies should be provided.

 

4. The study’s core intervention—elastic taping—lacks sufficient discussion regarding its physiological mechanisms of action. In particular, the explanation of how taping might promote lymphatic drainage or reduce subcutaneous bleeding during the acute postoperative period is superficial and unconvincing. A deeper discussion of the underlying mechanisms and reference to prior mechanistic studies would improve the paper’s scientific credibility.

 

5. Lastly, the short follow-up period, limited to 7 days postoperatively, should be acknowledged as a limitation. Parameters such as edema, skin elasticity, and functional recovery often continue to evolve beyond the first postoperative week. Extending the evaluation to postoperative days 14 or 21 would provide more robust insights into the intervention’s longer-term efficacy.

 

 

 

Author Response

Please see the attachment in the box.

Author Response File: Author Response.pdf