Tissue Adhesive for Wound Closure Reduces Immediate Postoperative Wound Dressing Changes After Primary TKA: A...

Area of Science:

• Orthopedic Surgery
• Wound Management
• Biomaterials

Background:

• Prolonged wound drainage post-total knee arthroplasty (TKA) increases infection risk.
• Tissue adhesive is a potential adjunct for TKA wound closure to minimize drainage.
• Limited data exists on tissue adhesive efficacy in fast-track TKA settings.

Purpose of the Study:

• To evaluate the impact of high-viscosity tissue adhesive on postoperative wound drainage in simultaneous bilateral TKA.
• To assess wound healing using the ASEPSIS score at 3 weeks post-TKA.
• To compare the number of dressing changes within 72 hours post-TKA between standard closure and tissue adhesive closure.

Main Methods:

• A randomized controlled trial involving 29 patients (58 knees) undergoing simultaneous bilateral TKA.
• One knee received standard three-layer closure; the contralateral knee received standard closure supplemented with tissue adhesive.
• Wound drainage was quantified by the number of dressing changes required within 72 hours; wound healing was assessed via ASEPSIS score at 3 weeks.

Main Results:

• Knees treated with tissue adhesive had significantly fewer dressing changes (median 0 vs. 1-2, p=0.001).
• 59% of tissue adhesive knees required no dressing changes before discharge, compared to 24% in the control group (p=0.02).
• No significant difference in ASEPSIS scores was observed between the groups at 3 weeks.

Conclusions:

• Tissue adhesive effectively reduces the number of dressing changes needed post-TKA.
• The use of tissue adhesive did not alter wound appearance or healing at 3 weeks, as per ASEPSIS scores.
• Future studies should investigate cost-effectiveness and long-term wound healing and infection rates.