A Prospective, Randomized and Controlled Study on Tissue Adhesive for Skin Incision in Total Knee Arthroplasty

Xiangpeng Kong, Minzhi Yang, Renwen Guo, Jiying Chen, Wei Chai, Yan Wang, Xiangpeng Kong, Minzhi Yang, Renwen Guo, Jiying Chen, Wei Chai, Yan Wang

Abstract

Background: The study focusing on the tissue adhesive in total knee arthroplasty (TKA) was rare. This study aimed to evaluate the clinical outcomes and economic costs of tissue adhesive when acting as the adjunct to standard incision closure in TKA.

Patients and methods: From September 2019 to November 2019, we prospectively enrolled the consecutive patients who underwent simultaneous bilateral TKA in our institute. The allocation using the tissue adhesive was done after the subcuticular suture in right knee first and another method was applied in the left knee automatically. The patients' demographics, length of stay (LOS), times of dressing changes and incision-related cost, range of motion (ROM), incision-related complications and incision evaluation scores were recorded.

Results: Thirty-two patients were enrolled in this study and followed at two months after surgery. In the knees of tissue adhesive, the times of dressing change and patient scar assessment scores (PSAS) were significantly less than those standard skin closure (p=0.000; p=0.003). Although there were no significant differences of the delayed discharge, incision-related cost, ROM, incision-related complications and Vancouver scar score (VSS) between two groups, 65.6% (21/32) patients preferred the tissue adhesive and only 15.6% (5/32) patients preferred the standard incision closure.

Conclusion: Tissue adhesive could effectively reduce postoperative wound drainage and improve patients' satisfaction rate with no difference in medical costs and ROM in TKA. The application of tissue adhesive and subcuticular sutures might be one safe and convenient method of skin closure in TKA.

Chinese clinical trial registry: ChiCTR1900025730; Registered 6 September 2019.

Keywords: dressing change; incision closure; tissue adhesive; total knee arthroplasty.

Conflict of interest statement

The authors report no conflicts of interest in this work.

© 2020 Kong et al.

Figures

Figure 1
Figure 1
The appearances of bilateral incisions in the operating room (right: tissue adhesive group; left: control group).
Figure 2
Figure 2
Flow chart of patient enrollment in this prospective study.
Figure 3
Figure 3
The preference distribution for incision closure in the thirty-two patients.
Figure 4
Figure 4
The appearances of bilateral incisions at postoperative two month (right: tissue adhesive group; left: control group).

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