Liu Te, Tao Ye, Zhao Runkai, Hua Yanfan, Feng Zeyu, Zheng Qingyuan, Zhang Guoqiang, Geng Lei, Fu Jun, Qian Wenwei, Ni Ming, Wang Weijun
Department of Orthopedics, The First Medical Center, Chinese PLA General Hospital, Beijing, 100853, China.
Department of Orthopedics, The Fourth Medical Center, Chinese PLA General Hospital, Beijing, 100036, China.
Arthroplasty. 2024 Sep 11;6(1):51. doi: 10.1186/s42836-024-00271-1.
Good wound healing is critical to infection prophylaxis and satisfactory rehabilitation in Total Knee Arthroplasty (TKA). Currently, two techniques, i.e., barbed continuous subcuticular suture without skin adhesive or combined use skin adhesive (n-butyl-2) are being used for superficial wound closure of TKA. While a new skin adhesive (2-octyl) with self-adhesive mesh has been employed as an alternative to conventional surgical skin closure in TKA, its superiority, especially in reducing wound complications and improving wound cosmetic outcomes has not been investigated. This study aimed to compare 2-octyl, n-butyl-2, and no skin adhesive in terms of safety and efficacy in TKA superficial wound closure.
We conducted a multicenter, prospective, randomized controlled study in 105 patients undergoing primary TKA between May 2022 and October 2023. Each patient's knee was randomized to receive 2-octyl, n-butyl-2, or no skin adhesive skin closure with all using barbed continuous sutures in deep tissue. Wounds were followed 1, 3, 5 days, 2, 6 weeks, and 3 months after surgery. Wound discharge, complications, cosmetic outcomes, patient satisfaction, and wound-related costs were compared among these three methods.
Wound discharge was less in 2-octyl group and n-butyl-2 group than in non-adhesive group at 1 day, with the discharge only being less in 2-octyl group than in the non-adhesive group at day 3 and day 5 days (P < 0.05). There was no statistical difference in the incidence of other wound complications among the groups (P > 0.05). The 2-octyl group achieved better cosmetic effects than the other two groups in 6 weeks and 3 months (P < 0.05). Compared to the non-adhesive group, 2-octyl group scored higher in overall patient satisfaction score in 2 weeks and incurred lower costs (P < 0.05).
Skin closure in TKA using 2-octyl adhesive material showed superiority when compared to no skin adhesive or n-butyl-2, in reducing wound discharge, improving the cosmetic outcomes, without increasing wound complications. In addition, the use of 2-octyl yielded better patient satisfaction and also was less costly compared to no skin adhesive. Our study exhibited that 2-octyl was a safe and effective wound closure technique for patients undergoing TKA.
This study has been registered at Clinical Trials. Gov (No. ChiCTR210046442).
良好的伤口愈合对于全膝关节置换术（TKA）预防感染和实现满意的康复至关重要。目前，两种技术，即使用倒刺连续皮下缝合且不使用皮肤粘合剂或联合使用皮肤粘合剂（正丁基 -2），被用于TKA的浅表伤口闭合。虽然一种带有自粘网的新型皮肤粘合剂（2 - 辛基）已被用作TKA中传统手术皮肤闭合的替代方法，但其优越性，尤其是在减少伤口并发症和改善伤口美容效果方面尚未得到研究。本研究旨在比较2 - 辛基、正丁基 -2和不使用皮肤粘合剂在TKA浅表伤口闭合中的安全性和有效性。
我们在2022年5月至2023年10月期间对105例行初次TKA的患者进行了一项多中心、前瞻性、随机对照研究。将每位患者的膝关节随机分配接受2 - 辛基、正丁基 -2或不使用皮肤粘合剂的皮肤闭合，所有患者在深部组织均使用倒刺连续缝合。术后1天、3天、5天、2周、6周和3个月对伤口进行随访。比较这三种方法的伤口引流情况、并发症、美容效果、患者满意度和伤口相关费用。
术后1天，2 - 辛基组和正丁基 -2组的伤口引流少于无粘合剂组，仅在术后3天和5天时2 - 辛基组的引流少于无粘合剂组（P < 0.05）。各组间其他伤口并发症的发生率无统计学差异（P > 0.05）。在术后6周和3个月时，2 - 辛基组的美容效果优于其他两组（P < 0.05）。与无粘合剂组相比，2 - 辛基组在术后2周的总体患者满意度得分更高，且费用更低（P < 0.05）。
与不使用皮肤粘合剂或正丁基 -2相比，在TKA中使用2 - 辛基粘合剂材料进行皮肤闭合在减少伤口引流、改善美容效果方面具有优越性，且不增加伤口并发症。此外，与不使用皮肤粘合剂相比，使用2 - 辛基可提高患者满意度且成本更低。我们的研究表明，2 - 辛基对接受TKA的患者是一种安全有效的伤口闭合技术。
本研究已在ClinicalTrials.Gov注册（编号：ChiCTR210046442）。
