2-Octyl Cyanoacrylate Topical Adhesive as an Alternative to Subcuticular Suture for Skin Closure After Total Knee Arthroplasty: A Randomized Controlled Trial in the Same Patient

Choi, Keun Young; Koh, In Jun; Kim, Man Soo; Park, Dong Chul; Sung, Yong Gyu

doi:10.1016/j.arth.2021.04.033

Cited by 14 publications

(16 citation statements)

References 22 publications

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“…Contrary to our opinion, Nepal et al performed a randomized control trial and reported that subcuticular sutures and staples were comparable wound closure options relative to cosmetic outcomes, patient satisfaction, functional outcomes, and wound complication rates after TKA [49] . Concealed cosmetic closure [50] and Dermabond Prineo [51] may be effective modalities for skin closure after TKA that provide superior cosmetic healing with minimal complications, thereby leading to improved long-term patient satisfaction. However, studies have not provided a clear evidence-based answer regarding which closure method is optimal for TKA; therefore, more high-quality evidence-based studies are needed before the final conclusion can be determined [52] .…”

Section: Discussionmentioning

confidence: 99%

Factors contributing to 1-year dissatisfaction after total knee arthroplasty: a nomogram prediction model

Muertizha

Cai

et al. 2022

J Orthop Surg Res

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Background Identifying risk factors and early intervention are critical for improving the satisfaction rate of total knee arthroplasty (TKA). Our study aimed to identify patient-specific variables and establish a nomogram model to predict dissatisfaction at 1 year after TKA. Methods This prospective cohort study involved 208 consecutive primary TKA patients with end-stage arthritis who completed self-reported measures preoperatively and at 1 year postoperatively. All participants were randomized into a training cohort (n = 154) and validation cohort (n = 54). Multiple regression models with preoperative and postoperative factors were used to establish the nomogram model for dissatisfaction at 1 year postoperatively. The least absolute shrinkage and selection operator method was used to screen the suitable and effective risk factors (demographic variables, preoperative variables, surgical variable, and postoperative variables) collected. These variables were compared between the satisfied and dissatisfied groups in the training cohort. The receiver operating characteristic (ROC) curve, calibration plot, and decision curve analysis were used to validate the discrimination, calibration, and clinical usefulness of the model. Results were evaluated by internal validation of the validation cohort. Results The overall satisfaction rate 1 year after TKA was 77.8%. The nomogram prediction model included the following risk factors: gender; primary diagnosis; postoperative residual pain; poor postoperative range of motion; wound healing; and the rate of change in the degree of coronal lower limb alignment (hip–knee–ankle angle, HKA).The ROC curves of the training and validation cohorts were 0.9206 (95% confidence interval [CI], 0.8785–0.9627) and 0.9662 (0.9231, 1.0000) (95% CI, 0.9231, 1.0000), respectively. The Hosmer–Lemeshow test showed good calibration of the nomogram (training cohort, p = 0.218; validation cohort, p = 0.103). Conclusion This study developed a prediction nomogram model based on partially modifiable risk factors for predicting dissatisfaction 1 year after TKA. This model demonstrated good discriminative capacity for identifying those at greatest risk for dissatisfaction and may help surgeons and patients identify and evaluate the risk factors for dissatisfaction and optimize TKA outcomes.

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Section: Discussionmentioning

confidence: 99%

Factors contributing to 1-year dissatisfaction after total knee arthroplasty: a nomogram prediction model

Muertizha

Cai

et al. 2022

J Orthop Surg Res

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“…Studies have shown that TAs can be used effectively in total hip and knee arthroplasty, oncological surgery, and spine surgery. 4,[7][8][9][10][11][12][13][14][15] While there have been reports of dermatitis and cellulitis after the use of TAs, these are rare. 10,16 In 2020, Kong et al 13 demonstrated that the use of TAs on total hip arthroplasty wounds was associated with significantly reduced postoperative wound drainage and increased patient satisfaction when compared to standard wound closure.…”

Section: Introductionmentioning

confidence: 99%

Optimization of tissue adhesive curing time for surgical wound closure

et al. 2022

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Aims Tissue adhesives (TAs) are a commonly used adjunct to traditional surgical wound closures. However, TAs must be allowed to dry before application of a surgical dressing, increasing operating time and reducing intraoperative efficiency. The goal of this study is to identify a practical method for decreasing the curing time for TAs. Methods Six techniques were tested to determine which one resulted in the quickest drying time for 2-octyle cyanoacrylate (Dermabond) skin adhesive. These were nothing (control), fanning with a hand (Fanning), covering with a hand (Covering), bringing operating room lights close (OR Lights), ultraviolet lights (UV Light), or prewarming the TA applicator in a hot water bath (Hot Water Bath). Equal amounts of TA were applied to a reproducible plexiglass surface and allowed to dry while undergoing one of the six techniques. The time to complete dryness was recorded for ten specimens for each of the six techniques. Results Use of the Covering, OR Lights, and Hot Water Bath techniques were associated with a 25- (p = 0.042), 27- (p = 0.023), and 30-second (p = 0.009) reduction in drying time, respectively, when compared to controls. The UV Light (p = 0.404) and Fanning (p = 1.000) methods had no effect on drying time. Conclusion Use of the Covering, OR Lights, and Hot Water Bath techniques present a means for reducing overall operating time for surgeons using TA for closure augmentation, which can increase intraoperative efficiency. Further studies are needed to validate this in vivo. Cite this article: Bone Jt Open 2022;3(8):607–610.

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“…Skin adhesive materials have become increasingly popular in elective orthopedic surgery [ 14 , 16 , 18 – 20 , 22 , 23 ]. The Dermabond Prineo topical skin adhesive (Ethicon, Somerville, NJ) consists of a 2-octyl cyanoacrylate liquid and a self-adhering polyester mesh with benzalkonium chloride.…”

Section: Introductionmentioning

confidence: 99%

“…Previous studies have reported the superiority of Dermabond Prineo skin adhesive in terms of cosmetic outcomes, lesser wound discharge, cost-effectiveness, and shorter length of hospital stay when used in hip and knee arthroplasty [ 15 , 19 , 20 , 22 , 23 ]. Despite these advantages and convenience in use, several recent studies have reported complications associated with its use; these are being increasingly reported as the use of the material has steadily increased.…”

Section: Introductionmentioning

confidence: 99%

Comparison of 2-octyl cyanoacrylate skin adhesive and interrupted polypropylene sutures for wound closure in total ankle arthroplasty

Lee

Kwak

2021

J Orthop Surg Res

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Background Adhesive skin materials have increasingly been used in orthopedic surgery. We aimed to compare the efficacy and safety of skin adhesive (2-octyl cyanoacrylate and polymer mesh, Dermabond Prineo) and interrupted polypropylene sutures for wound closure in patients undergoing total ankle arthroplasty (TAA). Methods We prospectively enrolled 107 consecutive patients (108 ankles) undergoing TAA and divided them into two groups: skin adhesive group (36 ankles) and suture group (72 ankles). The primary outcome assessment included wound complications and patient satisfaction for wound cosmesis. The secondary outcome assessment included duration of surgery, length of hospital stay, and the Ankle Osteoarthritis Scale (AOS) pain and disability score. Results There was one case of allergic contact dermatitis, three cases of wound dehiscence, and one case of superficial surgical site infection in the skin adhesive group. Among them, one case each with allergic contact dermatitis and wound dehiscence finally progressed to deep surgical site infection. Three cases of wound dehiscence were also reported in the suture group; however, there was no case of surgical site infection. Patient satisfaction for wound cosmesis was significantly higher in the skin adhesive group than in the suture group (p = 0.001). There was no statistically significant difference between the groups in terms of secondary outcomes (p > 0.05). Conclusions Although the use of Dermabond Prineo showed better patient satisfaction for wound cosmesis, it showed significantly high wound complication rates and no other clinical benefits compared to interrupted polypropylene suture in TAA. Our results suggest that awareness of the possibility of wound complications is necessary when Dermabond Prineo is used in TAA.

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2-Octyl Cyanoacrylate Topical Adhesive as an Alternative to Subcuticular Suture for Skin Closure After Total Knee Arthroplasty: A Randomized Controlled Trial in the Same Patient

Cited by 14 publications

References 22 publications

Factors contributing to 1-year dissatisfaction after total knee arthroplasty: a nomogram prediction model

Factors contributing to 1-year dissatisfaction after total knee arthroplasty: a nomogram prediction model

Optimization of tissue adhesive curing time for surgical wound closure

Comparison of 2-octyl cyanoacrylate skin adhesive and interrupted polypropylene sutures for wound closure in total ankle arthroplasty

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