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



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.


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).


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).


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


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



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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