RSS-Feed abonnieren
Bitte kopieren Sie die angezeigte URL und fügen sie dann in Ihren RSS-Reader ein.
https://www.thieme-connect.de/rss/thieme/de/10.1055-s-00000161.xml
PDF herunterladen
J Knee Surg 2023; 36(03): 274-283
DOI: 10.1055/s-0041-1731740
DOI: 10.1055/s-0041-1731740
Original Article
Wound Management following Total Knee Arthroplasty: An Updated Review
Funding None.
Abstract
Optimal wound closure techniques following total knee arthroplasty (TKA) have focused on enhancing healing potential, preventing infection, yielding satisfactory cosmesis, and allowing early ambulation and functionality. An appropriate layered closure and management of the TKA typically involves addressing the (1) deep fascial layer; (2) subdermal layer; (3) intradermal layer, including the subcuticular region; and (4) final application of a specific aseptic dressing, each of which are covered here in detail. This focused critical review of the literature discusses traditional techniques used in all layers of wound closure following TKA while introducing several emerging popular techniques. For example, absorbable barbed skin sutures and occlusive dressings have the potential to reduce operative time, limit the need for early postoperative visits, obviate the need for suture or staple removal, and safely promote patient communication via telemedicine. As novel wound closure techniques continue to emerge and traditional approaches are improved upon, future comparative studies will assist in elucidating the key advantages of various options. In an extremely important field that has tremendous variability, these efforts may enable the reaching of a classically elusive standard of care for these techniques.
Publikationsverlauf
Eingereicht: 11. Februar 2020
Angenommen: 31. Mai 2021
Artikel online veröffentlicht:
14. Juli 2021
© 2021. Thieme. All rights reserved.
Thieme Medical Publishers, Inc.
333 Seventh Avenue, 18th Floor, New York, NY 10001, USA
-
References
- 1 Inacio MCS, Paxton EW, Graves SE, Namba RS, Nemes S. Projected increase in total knee arthroplasty in the United States - an alternative projection model. Osteoarthritis Cartilage 2017; 25 (11) 1797-1803
- 2 Hampp EL, Chughtai M, Scholl LY. et al. Robotic-arm assisted total knee arthroplasty demonstrated greater accuracy and precision to plan compared with manual techniques. J Knee Surg 2019; 32 (03) 239-250
- 3 Rutherford RW, Jennings JM, Dennis DA. Enhancing recovery after total knee arthroplasty. Orthop Clin North Am 2017; 48 (04) 391-400
- 4 Galat DD, McGovern SC, Larson DR, Harrington JR, Hanssen AD, Clarke HD. Surgical treatment of early wound complications following primary total knee arthroplasty. J Bone Joint Surg Am 2009; 91 (01) 48-54
- 5 Bohl DD, Ondeck NT, Darrith B, Hannon CP, Fillingham YA, Della Valle CJ. Impact of operative time on adverse events following primary total joint arthroplasty. J Arthroplasty 2018; 33 (07) 2256-2262.e4
- 6 Morris MR, Bergum C, Jackson N, Markel DC. Decreased bacterial adherence, biofilm formation, and tissue reactivity of barbed monofilament suture in an in vivo contaminated wound model. J Arthroplasty 2017; 32 (04) 1272-1279
- 7 Bezwada RS, Jamiolkowski DD, Lee IY. et al. Monocryl suture, a new ultra-pliable absorbable monofilament suture. Biomaterials 1995; 16 (15) 1141-1148
- 8 Khiste SV, Ranganath V, Nichani AS. Evaluation of tensile strength of surgical synthetic absorbable suture materials: an in vitro study. J Periodontal Implant Sci 2013; 43 (03) 130-135
- 9 Byrne M, Aly A. The surgical needle. Aesthet Surg J 2019; 39 (Suppl_2): S73-S77
- 10 Kim KY, Anoushiravani AA, Long WJ, Vigdorchik JM, Fernandez-Madrid I, Schwarzkopf R. A meta-analysis and systematic review evaluating skin closure after total knee arthroplasty-what is the best method?. J Arthroplasty 2017; 32 (09) 2920-2927
- 11 Gurusamy KS, Toon CD, Allen VB, Davidson BR. Continuous versus interrupted skin sutures for non-obstetric surgery. Cochrane Database Syst Rev 2014; (02) CD010365
- 12 Wyles CC, Jacobson SR, Houdek MT. et al. The Chitranjan Ranawat Award: running subcuticular closure enables the most robust perfusion after TKA: a randomized clinical trial. Clin Orthop Relat Res 2016; 474 (01) 47-56
- 13 Roumeliotis L, Graham NM. Barbed suture and glue in skin closure during lower limb arthroplasty: reduced delayed discharge due to wound exudate. J Wound Care 2019; 28 (11) 784-789
- 14 McKenzie AR. An experimental multiple barbed suture for the long flexor tendons of the palm and fingers. Preliminary report. J Bone Joint Surg Br 1967; 49 (03) 440-447
- 15 Gamba C, Hinarejos P, Serrano-Chinchilla P. et al. Barbed sutures in total knee arthroplasty: are they really useful?: a randomized controlled trial. J Knee Surg 2020; 33 (09) 927-930
- 16 Levine BR, Ting N, Della Valle CJ. Use of a barbed suture in the closure of hip and knee arthroplasty wounds. Orthopedics 2011; 34 (09) e473-e475
- 17 Ting NT, Moric MM, Della Valle CJ, Levine BR. Use of knotless suture for closure of total hip and knee arthroplasties: a prospective, randomized clinical trial. J Arthroplasty 2012; 27 (10) 1783-1788
- 18 Sah AP. Is there an advantage to knotless barbed suture in TKA wound closure?: a randomized trial in simultaneous bilateral TKAs. Clin Orthop Relat Res 2015; 473 (06) 2019-2027
- 19 Vakil JJ, O'Reilly MP, Sutter EG, Mears SC, Belkoff SM, Khanuja HS. Knee arthrotomy repair with a continuous barbed suture: a biomechanical study. J Arthroplasty 2011; 26 (05) 710-713
- 20 Dennis DA, Komistek RD, Scuderi GR, Zingde S. Factors affecting flexion after total knee arthroplasty. Clin Orthop Relat Res 2007; 464: 53-60
- 21 Hanratty B, Bennett D, Thompson NW, Beverland DE. A randomised controlled trial investigating the effect of posterior capsular stripping on knee flexion and range of motion in patients undergoing primary knee arthroplasty. Knee 2011; 18 (06) 474-479
- 22 Faour M, Sodhi N, Khlopas A. et al. Knee position during surgical wound closure in total knee arthroplasty: a review. J Knee Surg 2018; 31 (01) 6-12
- 23 Komnik I, Weiss S, Fantini Pagani CH, Potthast W. Motion analysis of patients after knee arthroplasty during activities of daily living--a systematic review. Gait Posture 2015; 41 (02) 370-377
- 24 Vince KG, Abdeen A. Wound problems in total knee arthroplasty. Clin Orthop Relat Res 2006; 452: 88-90
- 25 Cerciello S, Morris BJ, Lustig S. et al. The role of wound closure in total knee arthroplasty: a systematic review on knee position. Knee Surg Sports Traumatol Arthrosc 2016; 24 (10) 3306-3312
- 26 King TV, Kish G, Eberhart RE, Holzaepfel JL. The “genuflex” skin closure for total knee arthroplasty. Orthopedics 1992; 15 (09) 1057-1058
- 27 Miller AG, Swank ML. Dermabond efficacy in total joint arthroplasty wounds. Am J Orthop 2010; 39 (10) 476-478
- 28 Sutton N, Schmitz ND, Johnston SS. Economic and clinical comparison of 2-octyl cyanoacrylate/polymer mesh tape with skin staples in total knee replacement. J Wound Care 2018; 27 (Suppl. 04) S12-S22
- 29 Madsen AM, Dow ML, Lohse CM, Tessmer-Tuck JA. Absorbable subcuticular staples versus suture for caesarean section closure: a randomised clinical trial. BJOG 2019; 126 (04) 502-510
- 30 Carli AV, Spiro S, Barlow BT, Haas SB. Using a non-invasive secure skin closure following total knee arthroplasty leads to fewer wound complications and no patient home care visits compared to surgical staples. Knee 2017; 24 (05) 1221-1226
- 31 Khan RJK, Fick D, Yao F. et al. A comparison of three methods of wound closure following arthroplasty: a prospective, randomised, controlled trial. J Bone Joint Surg Br 2006; 88 (02) 238-242
- 32 Holte AJ, Tofte JN, Dahlberg GJ, Noiseux N. Use of 2-octyl cyanoacrylate adhesive and polyester mesh for wound closure in primary knee arthroplasty. Orthopedics 2017; 40 (05) e784-e787
- 33 Evans DC, Evans BG. The effects of platelet-rich plasma and activated collagen on wound healing in primary total joint arthroplasty. Orthopedics 2018; 41 (02) e262-e267
- 34 Muchedzi TA, Roberts SB. A systematic review of the effects of platelet rich plasma on outcomes for patients with knee osteoarthritis and following total knee arthroplasty. Surgeon 2018; 16 (04) 250-258
- 35 Morishita M, Ishida K, Matsumoto T, Kuroda R, Kurosaka M, Tsumura N. Intraoperative platelet-rich plasma does not improve outcomes of total knee arthroplasty. J Arthroplasty 2014; 29 (12) 2337-2341
- 36 Scuderi GR. Avoiding postoperative wound complications in total joint arthroplasty. J Arthroplasty 2018; 33 (10) 3109-3112
- 37 Sharma S, Iorio R, Specht LM, Davies-Lepie S, Healy WL. Complications of femoral nerve block for total knee arthroplasty. Clin Orthop Relat Res 2010; 468 (01) 135-140
- 38 Plate JF, Seyler TM, Halvorson JJ, Santago II AC, Lang JE. Non-anatomical capsular closure of a standard parapatellar knee arthrotomy leads to patellar maltracking and decreased range of motion: a cadaver study. Knee Surg Sports Traumatol Arthrosc 2014; 22 (03) 543-549
- 39 Osei DA, Rebehn KA, Boyer MI. Soft-tissue defects after total knee arthroplasty: management and reconstruction. J Am Acad Orthop Surg 2016; 24 (11) 769-779
- 40 Meek RMD, Greidanus NV, McGraw RW, Masri BA. The extensile rectus snip exposure in revision of total knee arthroplasty. J Bone Joint Surg Br 2003; 85 (08) 1120-1122
- 41 Nestor BJ, Toulson CE, Backus SI, Lyman SL, Foote KL, Windsor RE. Mini-midvastus vs standard medial parapatellar approach: a prospective, randomized, double-blinded study in patients undergoing bilateral total knee arthroplasty. J Arthroplasty 2010; 25 (06) 5-11 , 11.e1
- 42 Khlopas A, Sodhi N, Anis HK, Ehiorobo J, Sultan AA, Mont MA. A systematic review of suture technologies in total knee arthroplasty. Surg Technol Int 2019; 34: 391-396
- 43 Sundaram K, Piuzzi NS, Patterson BM, Stearns KL, Krebs VE, Mont MA. Skin closure with 2-octyl cyanoacrylate and polyester mesh after primary total knee arthroplasty offers superior cosmetic outcomes and patient satisfaction compared to staples: a prospective trial. Eur J Orthop Surg Traumatol 2020; 30 (03) 447-453
- 44 Gililland JM, Anderson LA, Sun G, Erickson JA, Peters CL. Perioperative closure-related complication rates and cost analysis of barbed suture for closure in TKA. Clin Orthop Relat Res 2012; 470 (01) 125-129
- 45 Sakdinakiattikoon M, Tanavalee A. Continuous barbed suture versus knotted interrupted suture for wound closure in total knee arthroplasty: a prospective randomized study. J Med Assoc Thai 2019; x: x
- 46 Chan VWK, Chan PK, Chiu KY, Yan CH, Ng FY. Does barbed suture lower cost and improve outcome in total knee arthroplasty?: A randomized controlled trial. J Arthroplasty 2017; 32 (05) 1474-1477
- 47 Krebs VE, Elmallah RK, Khlopas A. et al. Wound closure techniques for total knee arthroplasty: an evidence-based review of the literature. J Arthroplasty 2018; 33 (02) 633-638
- 48 Maheshwari AV, Naziri Q, Wong A, Burko I, Mont MA, Rasquinha VJ. Barbed sutures in total knee arthroplasty: are these safe, efficacious, and cost-effective?. J Knee Surg 2015; 28 (02) 151-156
- 49 Emerson Jr RH, Ayers C, Head WC, Higgins LL. Surgical closing in primary total knee arthroplasties: flexion versus extension. Clin Orthop Relat Res 1996; (331) 74-80
- 50 Kobayashi S, Niki Y, Harato K, Udagawa K, Matsumoto M, Nakamura M. The effects of barbed suture on watertightness after knee arthrotomy closure: a cadaveric study. J Orthop Surg Res 2018; 13 (01) 323
- 51 Wagenaar FBM, Löwik CAM, Zahar A, Jutte PC, Gehrke T, Parvizi J. Persistent wound drainage after total joint arthroplasty: a narrative review. J Arthroplasty 2019; 34 (01) 175-182
- 52 Yuenyongviwat V, Iamthanaporn K, Hongnaparak T, Tangtrakulwanich B. A randomised controlled trial comparing skin closure in total knee arthroplasty in the same knee: nylon sutures versus skin staples. Bone Joint Res 2016; 5 (05) 185-190
- 53 Krishnan R, MacNeil SD, Malvankar-Mehta MS. Comparing sutures versus staples for skin closure after orthopaedic surgery: systematic review and meta-analysis. BMJ Open 2016; 6 (01) e009257
- 54 Patel RM, Cayo M, Patel A, Albarillo M, Puri L. Wound complications in joint arthroplasty: comparing traditional and modern methods of skin closure. Orthopedics 2012; 35 (05) e641-e646
- 55 Slade Shantz JA, Vernon J, Morshed S, Leiter J, Stranges G. Sutures versus staples for wound closure in orthopaedic surgery: a pilot randomized controlled trial. Patient Saf Surg 2013; 7 (01) 6
- 56 Alnachoukati O, Emerson R, Muraguri M. Non-invasive, zip type skin closure device vs. conventional staples in total knee arthroplasty: which method holds greater potential for bundled payments?. Cureus 2019; 11 (03) e4281
- 57 Benner RW, Behrens JP. A novel skin closure device for total knee arthroplasty: randomized controlled trial versus staples. J Knee Surg 2020; 33 (11) 1116-1120
- 58 Vince K, Chivas D, Droll KP. Wound complications after total knee arthroplasty. J Arthroplasty 2007; 22 (04, Suppl 1): 39-44
- 59 Galat DD, McGovern SC, Hanssen AD, Larson DR, Harrington JR, Clarke HD. Early return to surgery for evacuation of a postoperative hematoma after primary total knee arthroplasty. J Bone Joint Surg Am 2008; 90 (11) 2331-2336
- 60 Kuo FC, Chen B, Lee MS, Yen SH, Wang JW. AQUACEL® Ag surgical dressing reduces surgical site infection and improves patient satisfaction in minimally invasive total knee arthroplasty: a prospective, randomized, controlled study. BioMed Res Int 2017; 2017: 1262108
- 61 Ravenscroft MJ, Harker J, Buch KA. A prospective, randomised, controlled trial comparing wound dressings used in hip and knee surgery: Aquacel and Tegaderm versus Cutiplast. Ann R Coll Surg Engl 2006; 88 (01) 18-22
- 62 Loveluck J, Copeland T, Hill J, Hunt A, Martin R. Biomechanical modeling of the forces applied to closed incisions during single-use negative pressure wound therapy. Eplasty 2016; 16: e20
- 63 El-Gazzar Y, Smith DC, Kim SJ. et al. The use of dermabond® as an adjunct to wound closure after total knee arthroplasty: examining immediate post-operative wound drainage. J Arthroplasty 2013; 28 (04) 553-556
- 64 Takayama S, Yamamoto T, Tsuchiya C, Noguchi H, Sato J, Ishii Y. Comparing Steri-Strip and surgical staple wound closures after primary total knee arthroplasties. Eur J Orthop Surg Traumatol 2017; 27 (01) 113-118
- 65 Holm C, Petersen JS, Grønboek F, Gottrup F. Effects of occlusive and conventional gauze dressings on incisional healing after abdominal operations. Eur J Surg 1998; 164 (03) 179-183
- 66 Michie DD, Hugill JV. Influence of occlusive and impregnated gauze dressings on incisional healing: a prospective, randomized, controlled study. Ann Plast Surg 1994; 32 (01) 57-64
- 67 Vasconcelos A, Cavaco-Paulo A. Wound dressings for a proteolytic-rich environment. Appl Microbiol Biotechnol 2011; 90 (02) 445-460
- 68 Grosso MJ, Berg A, LaRussa S, Murtaugh T, Trofa DP, Geller JA. Silver-impregnated occlusive dressing reduces rates of acute periprosthetic joint infection after total joint arthroplasty. J Arthroplasty 2017; 32 (03) 929-932
- 69 Springer BD, Beaver WB, Griffin WL, Mason JB, Odum SM. Role of surgical dressings in total joint arthroplasty: a randomized controlled trial. Am J Orthop 2015; 44 (09) 415-420
- 70 Chalmers BP, Melugin HP, Sculco PK. et al. Characterizing the diagnosis and treatment of allergic contact dermatitis to 2-octyl cyanoacrylate used for skin closure in elective orthopedic surgery. J Arthroplasty 2017; 32 (12) 3742-3747
- 71 Eggers MD, Fang L, Lionberger DR. A comparison of wound closure techniques for total knee arthroplasty. J Arthroplasty 2011; 26 (08) 1251-8.e1 , 4
- 72 Morykwas MJ, Argenta LC, Shelton-Brown EI, McGuirt W. Vacuum-assisted closure: a new method for wound control and treatment: animal studies and basic foundation. Ann Plast Surg 1997; 38 (06) 553-562
- 73 Sinha K, Chauhan VD, Maheshwari R, Chauhan N, Rajan M, Agrawal A. Vacuum assisted closure therapy versus standard wound therapy for open musculoskeletal injuries. Adv Orthop 2013; 2013: 245940
- 74 Redfern RE, Cameron-Ruetz C, O'Drobinak SK, Chen JT, Beer KJ. Closed incision negative pressure therapy effects on postoperative infection and surgical site complication after total hip and knee arthroplasty. J Arthroplasty 2017; 32 (11) 3333-3339
- 75 Karlakki SL, Hamad AK, Whittall C, Graham NM, Banerjee RD, Kuiper JH. Incisional negative pressure wound therapy dressings (iNPWTd) in routine primary hip and knee arthroplasties: a randomised controlled trial. Bone Joint Res 2016; 5 (08) 328-337
- 76 Newman JM, Siqueira MBP, Klika AK, Molloy RM, Barsoum WK, Higuera CA. Use of closed incisional negative pressure wound therapy after revision total hip and knee arthroplasty in patients at high risk for infection: a prospective, randomized clinical trial. J Arthroplasty 2019; 34 (03) 554-559.e1