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

Authors Kong X, Yang M, Guo R, Chen J, Chai W, Wang Y

Received 26 April 2020

Accepted for publication 4 August 2020

Published 24 August 2020 Volume 2020:16 Pages 795—802


Checked for plagiarism Yes

Review by Single anonymous peer review

Peer reviewer comments 3

Editor who approved publication: Professor Deyun Wang

Xiangpeng Kong,1 Minzhi Yang,1,2 Renwen Guo,1 Jiying Chen,1 Wei Chai,1 Yan Wang1

1Department of Orthopaedics, Chinese PLA General Hospital, Beijing, People’s Republic of China ; 2Nankai University, Tianjin, People’s Republic of China

Correspondence: Wei Chai; Yan Wang Email;

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: total knee arthroplasty, tissue adhesive, incision closure, dressing change

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