Tissue adhesive for wound closure, as adjunct to staples, reduces postoperative wound drainage after total knee arthroplasty
Background Wound drainage after total knee or hip arthroplasty is a relatively frequent complication. It results in delayed mobilization, prolonged hospital stay, increased costs and is associated with an increased risk of infection. In this study, tissue adhesive was administered as an adjunct to s...
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| Veröffentlicht in: | Archives of orthopaedic and trauma surgery 2024-12, Vol.145 (1), p.56 |
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| creator | Dijkman, C. Thomas, A. R. van Boekel, L. Oost, I. Koenraadt -Van van Geenen, R. C. I. |
| description | Background
Wound drainage after total knee or hip arthroplasty is a relatively frequent complication. It results in delayed mobilization, prolonged hospital stay, increased costs and is associated with an increased risk of infection. In this study, tissue adhesive was administered as an adjunct to skin closure with staples.
Methods
From February 2017, in a cohort of 1000 consecutive patients receiving primary total hip, total knee (TKA) or unicondylar knee arthroplasty, tissue adhesive was administered after skin closure with staples. Patients were prospectively analyzed for increased duration of hospital admission due to wound drainage. This cohort was compared to a consecutive cohort of 1000 patients before February 2017, treated with the same perioperative protocol, except for administration of tissue adhesive for skin closure. Difference in number of patients requiring prolonged hospital stay due to wound drainage was assessed between the two cohorts. Besides, costs of tissue adhesive were compared to change in hospital admission costs to assess the cost-effectiveness.
Results
The number of patients requiring prolonged hospital admission due to wound drainage was significantly reduced in the study group compared to the group not treated with tissue adhesive (39/990 patients vs. 68/961 patients,
p
= 0.002). The mean number of extra days of hospital admission due to wound drainage was also significantly lower in the tissue adhesive cohort (0.06 vs. 0.13 days). The mean number of extra days in hospital only proved to be significant in the TKA cohort. Total money saved by preventing prolonged hospital admission in general cohort amounted €19,610.
Conclusion
This study proves that tissue adhesive as an adjunct to staples for wound closure after total knee arthroplasty reduces wound drainage and is cost effective. Besides, this could potentially lead to lower rates of periprosthetic joint infection. Therefore, the use of tissue adhesive in total knee arthroplasty would be recommended. |
| doi_str_mv | 10.1007/s00402-024-05658-y |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_pubme</sourceid><recordid>TN_cdi_proquest_miscellaneous_3146852078</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>3145273181</sourcerecordid><originalsourceid>FETCH-LOGICAL-p128y-9de7d0bfb9055f5d3f2637bbf3f3e4e58897a61beb38fffd4c1f9000edc2eb4d3</originalsourceid><addsrcrecordid>eNpdkUFv1DAQhS0EokvhD3BAlrhwaGAcx4lzRBUUpEpcytly4nGbJRsHj90qEj8eL1uExGmkme89Pc1j7LWA9wKg-0AADdQV1E0FqlW62p6wnWhkU8letE_ZDnrZVhqUOGMviPYAotY9PGdnsm81iK7dsV83E1FGbt0d0nSP3IfIH0JeHB_nQDniBbdUzvu8jImnwCnZdUa64BFdHpH4GiiFFaNNR_1J66KdFntbfH3CWGTJzvzHgmUR010M62wpbS_ZM29nwleP85x9__zp5vJLdf3t6uvlx-tqLYG3qnfYORj80INSXjnp61Z2w-Cll9ig0rrvbCsGHKT23rtmFL4HAHRjjUPj5Dl7d_JdY_iZkZI5TDTiPNsFQyYjRdNqVUOnC_r2P3QfclxKuiOl6k4KLQr15pHKwwGdWeN0sHEzf_9aAHkCqJyWW4z_bASYY3vm1J4p7Zk_7ZlN_gYJSo33</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>3145273181</pqid></control><display><type>article</type><title>Tissue adhesive for wound closure, as adjunct to staples, reduces postoperative wound drainage after total knee arthroplasty</title><source>MEDLINE</source><source>SpringerNature Complete Journals</source><creator>Dijkman, C. ; Thomas, A. R. ; van Boekel, L. ; Oost, I. Koenraadt -Van ; van Geenen, R. C. I.</creator><creatorcontrib>Dijkman, C. ; Thomas, A. R. ; van Boekel, L. ; Oost, I. Koenraadt -Van ; van Geenen, R. C. I.</creatorcontrib><description>Background
Wound drainage after total knee or hip arthroplasty is a relatively frequent complication. It results in delayed mobilization, prolonged hospital stay, increased costs and is associated with an increased risk of infection. In this study, tissue adhesive was administered as an adjunct to skin closure with staples.
Methods
From February 2017, in a cohort of 1000 consecutive patients receiving primary total hip, total knee (TKA) or unicondylar knee arthroplasty, tissue adhesive was administered after skin closure with staples. Patients were prospectively analyzed for increased duration of hospital admission due to wound drainage. This cohort was compared to a consecutive cohort of 1000 patients before February 2017, treated with the same perioperative protocol, except for administration of tissue adhesive for skin closure. Difference in number of patients requiring prolonged hospital stay due to wound drainage was assessed between the two cohorts. Besides, costs of tissue adhesive were compared to change in hospital admission costs to assess the cost-effectiveness.
Results
The number of patients requiring prolonged hospital admission due to wound drainage was significantly reduced in the study group compared to the group not treated with tissue adhesive (39/990 patients vs. 68/961 patients,
p
= 0.002). The mean number of extra days of hospital admission due to wound drainage was also significantly lower in the tissue adhesive cohort (0.06 vs. 0.13 days). The mean number of extra days in hospital only proved to be significant in the TKA cohort. Total money saved by preventing prolonged hospital admission in general cohort amounted €19,610.
Conclusion
This study proves that tissue adhesive as an adjunct to staples for wound closure after total knee arthroplasty reduces wound drainage and is cost effective. Besides, this could potentially lead to lower rates of periprosthetic joint infection. Therefore, the use of tissue adhesive in total knee arthroplasty would be recommended.</description><identifier>ISSN: 0936-8051</identifier><identifier>ISSN: 1434-3916</identifier><identifier>EISSN: 1434-3916</identifier><identifier>DOI: 10.1007/s00402-024-05658-y</identifier><identifier>PMID: 39680176</identifier><language>eng</language><publisher>Berlin/Heidelberg: Springer Berlin Heidelberg</publisher><subject>Adhesives ; Aged ; Arthroplasty, Replacement, Knee - adverse effects ; Arthroplasty, Replacement, Knee - methods ; Costs ; Drainage - methods ; Female ; Humans ; Joint replacement surgery ; Length of Stay - statistics & numerical data ; Male ; Medicine ; Medicine & Public Health ; Middle Aged ; Orthopedics ; Prospective Studies ; Surgical Stapling - economics ; Surgical Stapling - methods ; Surgical Wound Infection - prevention & control ; Tissue Adhesives - therapeutic use ; Wound Closure Techniques - economics</subject><ispartof>Archives of orthopaedic and trauma surgery, 2024-12, Vol.145 (1), p.56</ispartof><rights>The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature 2024 Springer Nature or its licensor (e.g. a society or other partner) holds exclusive rights to this article under a publishing agreement with the author(s) or other rightsholder(s); author self-archiving of the accepted manuscript version of this article is solely governed by the terms of such publishing agreement and applicable law.</rights><rights>2024. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.</rights><rights>Copyright Springer Nature B.V. Dec 2025</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><orcidid>0000-0001-7203-6158</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://link.springer.com/content/pdf/10.1007/s00402-024-05658-y$$EPDF$$P50$$Gspringer$$H</linktopdf><linktohtml>$$Uhttps://link.springer.com/10.1007/s00402-024-05658-y$$EHTML$$P50$$Gspringer$$H</linktohtml><link.rule.ids>314,780,784,27924,27925,41488,42557,51319</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/39680176$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Dijkman, C.</creatorcontrib><creatorcontrib>Thomas, A. R.</creatorcontrib><creatorcontrib>van Boekel, L.</creatorcontrib><creatorcontrib>Oost, I. Koenraadt -Van</creatorcontrib><creatorcontrib>van Geenen, R. C. I.</creatorcontrib><title>Tissue adhesive for wound closure, as adjunct to staples, reduces postoperative wound drainage after total knee arthroplasty</title><title>Archives of orthopaedic and trauma surgery</title><addtitle>Arch Orthop Trauma Surg</addtitle><addtitle>Arch Orthop Trauma Surg</addtitle><description>Background
Wound drainage after total knee or hip arthroplasty is a relatively frequent complication. It results in delayed mobilization, prolonged hospital stay, increased costs and is associated with an increased risk of infection. In this study, tissue adhesive was administered as an adjunct to skin closure with staples.
Methods
From February 2017, in a cohort of 1000 consecutive patients receiving primary total hip, total knee (TKA) or unicondylar knee arthroplasty, tissue adhesive was administered after skin closure with staples. Patients were prospectively analyzed for increased duration of hospital admission due to wound drainage. This cohort was compared to a consecutive cohort of 1000 patients before February 2017, treated with the same perioperative protocol, except for administration of tissue adhesive for skin closure. Difference in number of patients requiring prolonged hospital stay due to wound drainage was assessed between the two cohorts. Besides, costs of tissue adhesive were compared to change in hospital admission costs to assess the cost-effectiveness.
Results
The number of patients requiring prolonged hospital admission due to wound drainage was significantly reduced in the study group compared to the group not treated with tissue adhesive (39/990 patients vs. 68/961 patients,
p
= 0.002). The mean number of extra days of hospital admission due to wound drainage was also significantly lower in the tissue adhesive cohort (0.06 vs. 0.13 days). The mean number of extra days in hospital only proved to be significant in the TKA cohort. Total money saved by preventing prolonged hospital admission in general cohort amounted €19,610.
Conclusion
This study proves that tissue adhesive as an adjunct to staples for wound closure after total knee arthroplasty reduces wound drainage and is cost effective. Besides, this could potentially lead to lower rates of periprosthetic joint infection. Therefore, the use of tissue adhesive in total knee arthroplasty would be recommended.</description><subject>Adhesives</subject><subject>Aged</subject><subject>Arthroplasty, Replacement, Knee - adverse effects</subject><subject>Arthroplasty, Replacement, Knee - methods</subject><subject>Costs</subject><subject>Drainage - methods</subject><subject>Female</subject><subject>Humans</subject><subject>Joint replacement surgery</subject><subject>Length of Stay - statistics & numerical data</subject><subject>Male</subject><subject>Medicine</subject><subject>Medicine & Public Health</subject><subject>Middle Aged</subject><subject>Orthopedics</subject><subject>Prospective Studies</subject><subject>Surgical Stapling - economics</subject><subject>Surgical Stapling - methods</subject><subject>Surgical Wound Infection - prevention & control</subject><subject>Tissue Adhesives - therapeutic use</subject><subject>Wound Closure Techniques - economics</subject><issn>0936-8051</issn><issn>1434-3916</issn><issn>1434-3916</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2024</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNpdkUFv1DAQhS0EokvhD3BAlrhwaGAcx4lzRBUUpEpcytly4nGbJRsHj90qEj8eL1uExGmkme89Pc1j7LWA9wKg-0AADdQV1E0FqlW62p6wnWhkU8letE_ZDnrZVhqUOGMviPYAotY9PGdnsm81iK7dsV83E1FGbt0d0nSP3IfIH0JeHB_nQDniBbdUzvu8jImnwCnZdUa64BFdHpH4GiiFFaNNR_1J66KdFntbfH3CWGTJzvzHgmUR010M62wpbS_ZM29nwleP85x9__zp5vJLdf3t6uvlx-tqLYG3qnfYORj80INSXjnp61Z2w-Cll9ig0rrvbCsGHKT23rtmFL4HAHRjjUPj5Dl7d_JdY_iZkZI5TDTiPNsFQyYjRdNqVUOnC_r2P3QfclxKuiOl6k4KLQr15pHKwwGdWeN0sHEzf_9aAHkCqJyWW4z_bASYY3vm1J4p7Zk_7ZlN_gYJSo33</recordid><startdate>20241216</startdate><enddate>20241216</enddate><creator>Dijkman, C.</creator><creator>Thomas, A. R.</creator><creator>van Boekel, L.</creator><creator>Oost, I. Koenraadt -Van</creator><creator>van Geenen, R. C. I.</creator><general>Springer Berlin Heidelberg</general><general>Springer Nature B.V</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>K9.</scope><scope>NAPCQ</scope><scope>7X8</scope><orcidid>https://orcid.org/0000-0001-7203-6158</orcidid></search><sort><creationdate>20241216</creationdate><title>Tissue adhesive for wound closure, as adjunct to staples, reduces postoperative wound drainage after total knee arthroplasty</title><author>Dijkman, C. ; Thomas, A. R. ; van Boekel, L. ; Oost, I. Koenraadt -Van ; van Geenen, R. C. I.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-p128y-9de7d0bfb9055f5d3f2637bbf3f3e4e58897a61beb38fffd4c1f9000edc2eb4d3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2024</creationdate><topic>Adhesives</topic><topic>Aged</topic><topic>Arthroplasty, Replacement, Knee - adverse effects</topic><topic>Arthroplasty, Replacement, Knee - methods</topic><topic>Costs</topic><topic>Drainage - methods</topic><topic>Female</topic><topic>Humans</topic><topic>Joint replacement surgery</topic><topic>Length of Stay - statistics & numerical data</topic><topic>Male</topic><topic>Medicine</topic><topic>Medicine & Public Health</topic><topic>Middle Aged</topic><topic>Orthopedics</topic><topic>Prospective Studies</topic><topic>Surgical Stapling - economics</topic><topic>Surgical Stapling - methods</topic><topic>Surgical Wound Infection - prevention & control</topic><topic>Tissue Adhesives - therapeutic use</topic><topic>Wound Closure Techniques - economics</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Dijkman, C.</creatorcontrib><creatorcontrib>Thomas, A. R.</creatorcontrib><creatorcontrib>van Boekel, L.</creatorcontrib><creatorcontrib>Oost, I. Koenraadt -Van</creatorcontrib><creatorcontrib>van Geenen, R. C. I.</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Nursing & Allied Health Premium</collection><collection>MEDLINE - Academic</collection><jtitle>Archives of orthopaedic and trauma surgery</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Dijkman, C.</au><au>Thomas, A. R.</au><au>van Boekel, L.</au><au>Oost, I. Koenraadt -Van</au><au>van Geenen, R. C. I.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Tissue adhesive for wound closure, as adjunct to staples, reduces postoperative wound drainage after total knee arthroplasty</atitle><jtitle>Archives of orthopaedic and trauma surgery</jtitle><stitle>Arch Orthop Trauma Surg</stitle><addtitle>Arch Orthop Trauma Surg</addtitle><date>2024-12-16</date><risdate>2024</risdate><volume>145</volume><issue>1</issue><spage>56</spage><pages>56-</pages><issn>0936-8051</issn><issn>1434-3916</issn><eissn>1434-3916</eissn><abstract>Background
Wound drainage after total knee or hip arthroplasty is a relatively frequent complication. It results in delayed mobilization, prolonged hospital stay, increased costs and is associated with an increased risk of infection. In this study, tissue adhesive was administered as an adjunct to skin closure with staples.
Methods
From February 2017, in a cohort of 1000 consecutive patients receiving primary total hip, total knee (TKA) or unicondylar knee arthroplasty, tissue adhesive was administered after skin closure with staples. Patients were prospectively analyzed for increased duration of hospital admission due to wound drainage. This cohort was compared to a consecutive cohort of 1000 patients before February 2017, treated with the same perioperative protocol, except for administration of tissue adhesive for skin closure. Difference in number of patients requiring prolonged hospital stay due to wound drainage was assessed between the two cohorts. Besides, costs of tissue adhesive were compared to change in hospital admission costs to assess the cost-effectiveness.
Results
The number of patients requiring prolonged hospital admission due to wound drainage was significantly reduced in the study group compared to the group not treated with tissue adhesive (39/990 patients vs. 68/961 patients,
p
= 0.002). The mean number of extra days of hospital admission due to wound drainage was also significantly lower in the tissue adhesive cohort (0.06 vs. 0.13 days). The mean number of extra days in hospital only proved to be significant in the TKA cohort. Total money saved by preventing prolonged hospital admission in general cohort amounted €19,610.
Conclusion
This study proves that tissue adhesive as an adjunct to staples for wound closure after total knee arthroplasty reduces wound drainage and is cost effective. Besides, this could potentially lead to lower rates of periprosthetic joint infection. Therefore, the use of tissue adhesive in total knee arthroplasty would be recommended.</abstract><cop>Berlin/Heidelberg</cop><pub>Springer Berlin Heidelberg</pub><pmid>39680176</pmid><doi>10.1007/s00402-024-05658-y</doi><orcidid>https://orcid.org/0000-0001-7203-6158</orcidid></addata></record> |
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| identifier | ISSN: 0936-8051 |
| ispartof | Archives of orthopaedic and trauma surgery, 2024-12, Vol.145 (1), p.56 |
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| source | MEDLINE; SpringerNature Complete Journals |
| subjects | Adhesives Aged Arthroplasty, Replacement, Knee - adverse effects Arthroplasty, Replacement, Knee - methods Costs Drainage - methods Female Humans Joint replacement surgery Length of Stay - statistics & numerical data Male Medicine Medicine & Public Health Middle Aged Orthopedics Prospective Studies Surgical Stapling - economics Surgical Stapling - methods Surgical Wound Infection - prevention & control Tissue Adhesives - therapeutic use Wound Closure Techniques - economics |
| title | Tissue adhesive for wound closure, as adjunct to staples, reduces postoperative wound drainage after total knee arthroplasty |
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