Clinical outcome of different skin closure in total-knee arthroplasty: running subcuticular closure vs intermittent closure: A retrospective study

Medicine (Baltimore). 2020 Aug 21;99(34):e21947. doi: 10.1097/MD.0000000000021947.

Abstract

An intermittent closure with silk suture is routinely used for closing different surgical wounds. However, subcuticular closure with absorbable sutures has gained considerable attention due to convenience and better cosmetic appearance.To compare the clinical outcomes and risk of surgical-site infection of subcuticular and intermittent closure after total-knee arthroplasty (TKA), 106 patients that underwent TKA between January 2017 to June 2019 at the Department of Orthopedics in Xiangya Hospital of Centre South University were retrospectively assessed. Forty-three had received running subcuticular closure (group A) and 58 underwent intermittent closure (group B). The Knee Society score was measured before and 6 months after operation. Inflammation markers including the serum levels of procalcitonin, interleukin-6, and C-reactive protein, and the erythrocyte sedimentation rate were evaluated before operation, 1 day after and 1 month after operation. Patient satisfaction with the closure was evaluated using the Likert scale at the last follow-up.No significant difference was seen in the 6-month postoperative Knee Society score, or in the 1-day and 6-month postoperative inflammation marker levels between both groups (P > .05). Likert scores were higher in group A compared to group B (4.0 ± 1.0 vs 3.6 ± 1.2, P < .05).Running subcuticular closure after TKA results in a better appearance compared to intermittent closure, although neither method has an advantage in terms of efficacy and risk of infection.

Publication types

  • Comparative Study

MeSH terms

  • Aged
  • Arthroplasty, Replacement, Knee / methods*
  • Blood Sedimentation
  • C-Reactive Protein / analysis
  • China / epidemiology
  • Female
  • Humans
  • Inflammation / metabolism
  • Interleukin-6 / blood
  • Male
  • Middle Aged
  • Patient Satisfaction
  • Procalcitonin / blood
  • Retrospective Studies
  • Skin / pathology*
  • Surgical Wound Infection / epidemiology
  • Surgical Wound Infection / prevention & control
  • Sutures / trends*
  • Treatment Outcome
  • Wound Closure Techniques / trends*

Substances

  • Interleukin-6
  • Procalcitonin
  • C-Reactive Protein