P revious research [1, 3, 7, 9, 10] has supported many different wound closure techniques for use in TKA including staples, interrupted sutures, running barbed subcutaneous sutures, and subcuticular methods. A midline incision is generally used, but medial and lateral incisions have also been advocated to permit better kneeling ability after surgery or for other reasons [2, 6]. Subfacial vessels provide circulation to the skin, which perforate through the subcutaneous tissue layer [10]. Subfacial dissection of skin and subcutaneous tissue flaps preserve skin circulation while dissection into the subcutaneous layer disrupts skin circulation. Circulation to the skin over the knee occurs in a medial to lateral direction [12]. Sensory nerve supply follows the same direction. This is why sensation in the lateral skin flap is often diminished after TKA, and the lateral skin edge is generally more hypoxic than the medial skin edge [5]. Oxygenation of the skin edges is also reduced by knee flexion because this puts greater tension on the wound, while also decreasing to a maximum several days after surgery before returning toward normal [5]. The development of skin necrosis and postsurgery wound healing problems can lead to infection of the prosthetic components. These issues are influenced by many risk factors and comorbidities that are not under the control of the surgeon. Surgical technique, including the method of soft tissue dissection and wound closure, are also important in promoting primary wound healing. However, there is no clear consensus on the best method of wound closure in TKA. The study by Wyles et al. utilizes a sophisticated fluorescent imaging system following intravenous administration of dye to quantitate skin perfusion. This method is a valuable research tool that is more sensitive than other techniques, and also appears to be useful in clinical practice to help with treatment decisions. The authors This CORR Insights is a commentary on the article ‘‘The Chitranjan Ranawat Award: Running Subcuticular Closure Enables the Most Robust Perfusion After TKA: A Randomized Clinical Trial’’ by Wyles and colleagues available at: DOI: 10.1007/ s11999-015-4209-x. The author certifies that he, or any member of his immediate family, has no funding or commercial associations (eg, consultancies, stock ownership, equity interest, patent/ licensing arrangements, etc) that might pose a conflict of interest in connection with the submitted article. All ICMJE Conflict of Interest Forms for authors and Clinical Orthopaedics and Related Research editors and board members are on file with the publication and can be viewed on request. The opinions expressed are those of the writers, and do not reflect the opinion or policy of CORR or the Association of Bone and Joint Surgeons. This CORR Insights comment refers to the article available at DOI: 10.1007/s11999-0154209-x. M. D. Ries MD (&) Tahoe Fracture and Orthopaedic Clinic, 973 Mica Dr., Carson City, NV 89705, USA e-mail: riesm@orthosurg.ucsf.edu CORR Insights Published online: 1 April 2015 The Association of Bone and Joint Surgeons1 2015