Kong Xiangpeng, Yang Minzhi, Guo Renwen, Chen Jiying, Chai Wei, Wang Yan
Department of Orthopaedics, Chinese PLA General Hospital, Beijing, People's Republic of China.
Nankai University, Tianjin, People's Republic of China.
Ther Clin Risk Manag. 2020 Aug 24;16:795-802. doi: 10.2147/TCRM.S260007. eCollection 2020.
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.
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.
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.
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.
ChiCTR1900025730; Registered 6 September 2019.
专注于全膝关节置换术（TKA）中组织粘合剂的研究较少。本研究旨在评估组织粘合剂作为TKA标准切口闭合辅助手段时的临床疗效和经济成本。
2019年9月至2019年11月，我们前瞻性纳入了在我院同时接受双侧TKA的连续患者。在右膝皮下缝合后首先使用组织粘合剂进行切口闭合，左膝则自动采用另一种方法。记录患者的人口统计学数据、住院时间（LOS）、换药次数、切口相关费用、关节活动范围（ROM）、切口相关并发症及切口评估评分。
本研究共纳入32例患者，并在术后两个月进行随访。使用组织粘合剂的膝关节，换药次数和患者瘢痕评估评分（PSAS）显著低于标准皮肤闭合组（p = 0.000；p = 0.003）。尽管两组在延迟出院、切口相关费用、ROM、切口相关并发症及温哥华瘢痕评分（VSS）方面无显著差异，但65.6%（21/32）的患者更喜欢组织粘合剂，只有15.6%（5/32）的患者更喜欢标准切口闭合方式。
组织粘合剂可有效减少术后伤口引流，提高患者满意度，且在TKA中医疗成本和ROM方面无差异。组织粘合剂与皮下缝合的联合应用可能是TKA中一种安全便捷的皮肤闭合方法。
ChiCTR1900025730；2019年9月6日注册。
