Abstract
Introduction: Total joint arthroplasty is projected to expand rapidly by 2030. With large numbers of patients undergoing TJA, the choice of incisional closure has come into question. We compared the 2-Ocyl cyanoacrylate closure system of Dermabond ® Prineo ® with Exofin Fusion ® to compare rates of adverse wound outcomes after total joint arthroplasty. Secondary outcome measures were age, sex, and medical comorbidities between groups.Methods: We retrospectively reviewed adverse wound outcomes with skin closure in TJA in 281 patients (160 Dermabond Prineo and 121 Exofin Fusion). Clinical charts were analyzed out to the 6-week post-op visit.Results: The rate of overall adverse superficial wound outcomes was similar between the two groups with Dermabond Prineo (N=20) and Exofin Fusion (N=19). The rate of cellulitis was significantly higher for Dermabond Prineo when compared to Exofin Fusion (P=0.033). No other significant differences were found for rate of superficial or deep wound complications or for secondary outcomes.Conclusions: The two 2-octyl wound closure systems had similar adverse superficial wound complications. Except for Dermabond Prineo having a higher rate of post-operative cellulitis, there were no statistically significant differences for other superficial or deep adverse wound outcomes or secondary outcomes. A future randomized control trial or prospective cohort study is needed for a more robust analysis.
Highlights
Total joint arthroplasty is projected to expand rapidly by 2030
Except for Dermabond Prineo having a higher rate of post-operative cellulitis, there were no statistically significant differences for other superficial or deep adverse wound outcomes or secondary outcomes
Et al show that signs of superficial wound infections such as surgical site infections and prolonged drainage may lead to a 35 times increase risk of deep Periprosthetic joint infection (PJI), while Guirro, et al report that of 45 superficial wound infections in 3000 primary total knee arthroplasty (TKA) treated with oral antibiotics with or without surgical debridement, none led to deep PJIs at 70 months of followup[3,4]
Summary
Total joint arthroplasty is projected to expand rapidly by 2030. With large numbers of patients undergoing TJA, the choice of incisional closure has come into question. There are many choices of skin incision closure systems for total joint arthroplasty (TJA) These http://www.jbji.net include staples, suture, or newer methods of absorbable barbed suture with a tape and glue overlay to seal the incision for the first 10 to 14 postoperative days. According to “data on file,” the newer Exofin Fusion system from Chemence Medical, Inc. has a drying time of 38 seconds compared to 60 seconds for the Dermabond/Prineo tape system[6]. Both types of wound closure systems were combined with a 3-0 Stratafix ® monocryl (Ethicon, Inc., Somerville, NJ, USA) barbed suture in the subcutaneous tissue in this study[5]. No previous study to date has compared the adverse wound outcomes of the Exofin Fusion wound closure system to the extensively studied 2-octyl-2-cyanoacrylate Dermabond glue and Prineo tape system
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