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The authors are from the University of Iowa Roy J. and Lucille A. Carver College of Medicine (AJH, GJD) and the Department of Orthopaedics and Rehabilitation (JNT, NN), University of Iowa Hospitals and Clinics, Iowa City, Iowa.
Mr Holte, Dr Tofte, and Ms Dahlberg have no relevant financial relationships to disclose. Dr Noiseux is a paid consultant for Microport and Smith & Nephew, and his institution has received research support from DePuy and Zimmer-Biomet.
Wound closure in primary knee arthroplasty is important both for surgical success, by minimizing the risk of wound complications and infection, and for patient satisfaction with wound care and cosmesis. The use of 2-octyl cyanoacrylate adhesive (Dermabond; Ethicon, Somerville, New Jersey) and polyester mesh (Prineo; Ethicon) is a superficial wound closure technique that uses a topical skin glue and a self-adhering polyester mesh for wound closure of the most superficial skin layer. It is used as an alternative to staples or transcutaneous sutures for final wound closure. This technique can be used in combination with an all-in-one adhesive foam dressing (Mepilex Border; Molnlycke Health Care, Norcross, Georgia) to minimize wound care postoperatively.
The combination of 2-octyl cyanoacrylate adhesive and polyester mesh for superficial wound closure has been previously published in the plastic surgery literature, where it has been used primarily for high-tension wounds. Benefits include decreased closure time and decreased wound edge ischemia compared with sutures and staples. 1 Additionally, patients can shower immediately after surgery because of the watertight closure and can remove the dressing at home, obviating the need for an early follow-up visit to remove sutures or staples. Decreased operating time and cost 2,3 and improved cosmetic outcomes also have been reported. 1
The use of this closure technique for primary knee arthroplasty has not been reported previously. This study examined the use of this closure technique in a series of 321 primary total knee arthroplasty (TKA) procedures and 39 primary unicompartmental knee arthroplasty procedures. The goal of this study was to identify the incidence of complications after its use in primary knee arthroplasty and compare these data with historical rates in studies in which closure with sutures or staples was used. The authors hypothesized that this dressing protocol will minimize postoperative wound maintenance and complications.
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