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J Knee Surg 2023; 36(03): 274-283
DOI: 10.1055/s-0041-1731740
Original Article

Wound Management following Total Knee Arthroplasty: An Updated Review

Brandon H. Naylor
1   Northwell Health Orthopaedics, Lenox Hill Hospital, New York City, New York
,
John M. Tarazi
1   Northwell Health Orthopaedics, Lenox Hill Hospital, New York City, New York
,
Hytham S. Salem
1   Northwell Health Orthopaedics, Lenox Hill Hospital, New York City, New York
,
Steven F. Harwin
2   Department of Orthopaedic Surgery, Mount Sinai West Hospital, New York City, New York
,
Michael A. Mont
1   Northwell Health Orthopaedics, Lenox Hill Hospital, New York City, New York
› Author Affiliations Funding None.
› Further Information
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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.

Keywords

total knee arthroplasty - wound closure


Publication History

Received: 11 February 2020

Accepted: 31 May 2021

Article published online:
14 July 2021

© 2021. Thieme. All rights reserved.

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