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Skin closure with 2-octyl cyanoacrylate and polyester mesh after primary total knee arthroplasty offers superior cosmetic outcomes and patient satisfaction compared to staples: a prospective trial

  • Kavin Sundaram
  • Nicolas S. PiuzziEmail author
  • Brendan M. Patterson
  • Kim L. Stearns
  • Viktor E. Krebs
  • Michael A. Mont
Original Article • KNEE - ARTHROPLASTY
  • 5 Downloads

Abstract

Introduction

The goals of this study were to compare patient satisfaction and wound-related complications in patients receiving 2-octyl cyanoacrylate (glue) and polyester mesh for skin closure after primary total knee arthroplasty (TKA) versus staples.

Methods

A total of 60 knees in 54 patients undergoing TKA were enrolled in a prospective trial and randomized to receive either skin closure with glue and polyester mesh (n = 30) or a control group closed with staples (n = 30). Hollander wound cosmesis score (measured on a scale of 0–5, with 0 being the best) and visual analog scale (VAS) scores (range 0–100 mm) for patient satisfaction with wound cosmesis, as well as wound-related readmission, reoperation, and complications, including superficial surgical site infection, wound dehiscence, wound hematoma, stitch abscess, and wound discharge, were assessed at 6 weeks and 90 days after TKA. Baseline characteristics were not statistically significantly different between the groups (p > 0.05).

Results

At 6 weeks and 90 days, the Hollander wound cosmesis score was significantly lower (p < 0.01) in the glue and polyester mesh groups. Similarly, at 6 weeks and 90 days, the VAS for patient satisfaction with wound cosmesis was significantly higher (p < 0.01) in the glue and polyester mesh groups. The rate of superficial surgical site infection was 1/30 (3%) in glue and polyester mesh groups versus zero in the control group (p = 1.00). The rate of wound dehiscence was 1/30 (3%) in glue and polyester mesh groups versus zero in the control group (p = 1.00).

Conclusion

These results suggest that glue and polyester mesh closure may offer superior cosmetic outcomes to staples for skin closure in TKA.

Keywords

Total knee arthroplasty Total knee replacement Wound closure 2-octyl cyanoacrylate Staples Wound cosmesis Wound complications 

Notes

Acknowledgements

Funding was provided by Ethicon (Grant No. 15-206).

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Copyright information

© Springer-Verlag France SAS, part of Springer Nature 2019

Authors and Affiliations

  1. 1.Department of Orthopaedic SurgeryCleveland ClinicClevelandUSA
  2. 2.Department of Orthopaedic SurgeryLenox Hill HospitalNew YorkUSA

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