Department of Orthopaedic Surgery, Faculty of Medicine Siriraj Hospital, Mahidol University, 2 Wang Lang Road, Bangkok Noi, Bangkok, 10700, Thailand.
Arch Orthop Trauma Surg. 2020 Sep;140(9):1255-1263. doi: 10.1007/s00402-020-03479-3. Epub 2020 May 18.
Staples and subcuticular suture are commonly used wound closure techniques after total knee arthroplasty (TKA). To date, only a few studies have investigated the differences between these two wound closure methods in TKA. Accordingly, this study aimed to compare cosmetic outcome and patient satisfaction between staples and subcuticular suture for post-TKA wound closure.
This prospective randomized controlled trial included patients scheduled to undergo TKA at the Department of Orthopaedic Surgery of Siriraj Hospital (Bangkok, Thailand) during June 2018-March 2019. Patients were randomized into the staples or subcuticular suture groups. Hollander Wound Evaluation Scale (HWES), cosmetic-visual analogue scale (VAS), and patient satisfaction-VAS were evaluated at the 6-week and 3-month follow-ups. Functional outcome by the modified Knee Society Knee Scoring System and wound complications were also assessed.
Sixty-two patients (31 per group) were included. There were no significant differences in the HWES, cosmetic-VAS, patient satisfaction-VAS, or wound complication rate between groups at the 6-week or 3-month follow-ups. Wound closure time was significantly shorter in the staples group (p < 0.001), but the total operative time was not significantly different between groups. Modified knee score was significantly better in the suture group at 6 weeks (p = 0.024), but there was no significant difference between groups at 3 months. Significant association was observed between patient satisfaction-VAS and cosmetic-VAS at the 6-week (p = 0.03) and 3-month (p = 0.021) follow-ups.
Subcuticular suture and staples were found to be comparable wound-closure options after TKA relative to cosmetic outcome, patient satisfaction, functional outcome, and wound complication rate at 3-months post-operation.
在全膝关节置换术（TKA）后，通常使用缝线和皮下缝合来关闭伤口。迄今为止，只有少数研究调查了这两种伤口闭合方法在 TKA 中的差异。因此，本研究旨在比较 TKA 后缝线和皮下缝合的美容效果和患者满意度。
这是一项前瞻性随机对照试验，纳入了 2018 年 6 月至 2019 年 3 月在泰国 Siriraj 医院骨科接受 TKA 的患者。患者被随机分为缝线组或皮下缝合组。在 6 周和 3 个月随访时，采用 Hollander 伤口评估量表（HWES）、美容视觉模拟量表（VAS）和患者满意度 VAS 进行评估。还评估了改良膝关节学会膝关节评分系统的功能结果和伤口并发症。
共纳入 62 例患者（每组 31 例）。在 6 周和 3 个月随访时，两组间 HWES、美容 VAS、患者满意度 VAS 或伤口并发症发生率均无显著差异。缝线组的伤口闭合时间明显短于缝线组（p<0.001），但两组的总手术时间无显著差异。缝线组在 6 周时改良膝关节评分明显更好（p=0.024），但 3 个月时两组间无显著差异。在 6 周（p=0.03）和 3 个月（p=0.021）随访时，患者满意度 VAS 与美容 VAS 之间存在显著相关性。
在 TKA 后，与美容效果、患者满意度、功能结果和术后 3 个月的伤口并发症发生率相比，皮下缝合和缝线是两种可比较的伤口闭合选择。
