Abstract
BackgroundAdhesive 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).MethodsWe 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.ResultsThere 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).ConclusionsAlthough 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.
Highlights
Total ankle arthroplasty (TAA) has been steadily developed while overcoming the drawbacks of the past and is widely performed as a primary treatment for end-stage ankle arthritis [1,2,3,4,5,6,7,8,9]
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]
There were no significant differences in age, sex, presence of diabetes, number of current smokers and antithrombotic drug users, body mass index (BMI), preoperative diagnosis, follow-up period, and other medical conditions (p > 0.05) between the groups
Summary
Total ankle arthroplasty (TAA) has been steadily developed while overcoming the drawbacks of the past and is widely performed as a primary treatment for end-stage ankle arthritis [1,2,3,4,5,6,7,8,9]. 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. 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)
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