• Kavin Sundaram, Nicolas S Piuzzi, Brendan M Patterson, Kim L Stearns, Viktor E Krebs, and Michael A Mont.
• Department of Orthopaedic Surgery, Cleveland Clinic, A41, 9500 Euclid Ave., Cleveland, OH, 44195, USA.
• Eur J Orthop Surg Tr. 2020 Apr 1; 30 (3): 447-453.

IntroductionThe goals of this study were to compare patient satisfaction and wound-related complications in patients receiving 2-octyl cyanoacrylate (glue) and polyester mesh for skin closure after primary total knee arthroplasty (TKA) versus staples.MethodsA total of 60 knees in 54 patients undergoing TKA were enrolled in a prospective trial and randomized to receive either skin closure with glue and polyester mesh (n = 30) or a control group closed with staples (n = 30). Hollander wound cosmesis score (measured on a scale of 0-5, with 0 being the best) and visual analog scale (VAS) scores (range 0-100 mm) for patient satisfaction with wound cosmesis, as well as wound-related readmission, reoperation, and complications, including superficial surgical site infection, wound dehiscence, wound hematoma, stitch abscess, and wound discharge, were assessed at 6 weeks and 90 days after TKA. Baseline characteristics were not statistically significantly different between the groups (p > 0.05).ResultsAt 6 weeks and 90 days, the Hollander wound cosmesis score was significantly lower (p < 0.01) in the glue and polyester mesh groups. Similarly, at 6 weeks and 90 days, the VAS for patient satisfaction with wound cosmesis was significantly higher (p < 0.01) in the glue and polyester mesh groups. The rate of superficial surgical site infection was 1/30 (3%) in glue and polyester mesh groups versus zero in the control group (p = 1.00). The rate of wound dehiscence was 1/30 (3%) in glue and polyester mesh groups versus zero in the control group (p = 1.00).ConclusionThese results suggest that glue and polyester mesh closure may offer superior cosmetic outcomes to staples for skin closure in TKA.

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