Barbed sutures and skin adhesives improve wound closure in hip and knee arthroplasty.

Autor: Romanini E; RomaPro Centre for Hip and Knee Arthroplasty, Polo Sanitario San Feliciano, Rome, Italy., Zanoli GA; Casa di Cura Santa Maria Maddalena, Occhiobello, RO, Italy., Ascione T; Service of Infectious Diseases, AORN A. Cardarelli, Naples, Italy., Balato G; Department of Public Health, Federico II University of Naples, Italy., Baldini A; IFCA Institute, Florence, Italy., Foglia E; School of Management Engineering and Healthcare Datascience LAB, Carlo Cattaneo- LIUC University and LIUC Business School, Castellanza, VA, Italy., Pellegrini AV; UO CRIO, IRCCS Ospedale Galeazzi-Sant'Ambrogio, Milano, Italy., Verde F; IRCCS Ospedale San Raffaele, Milano, Italy., Zaffagnini S; Università di Bologna, Clinica Ortopedica e Traumatologica, Istituto Ortopedico Rizzoli, Bologna, Italy.
Jazyk: angličtina
Zdroj: Knee surgery, sports traumatology, arthroscopy : official journal of the ESSKA [Knee Surg Sports Traumatol Arthrosc] 2024 Feb; Vol. 32 (2), pp. 303-310. Date of Electronic Publication: 2024 Feb 06.
DOI: 10.1002/ksa.12055
Abstrakt: Purpose: This study aimed to formulate evidence-based recommendations for optimising wound management in hip and knee arthroplasty by exploring alternative methods such as barbed sutures and skin adhesives.
Methods: A Delphi panel, comprising seven orthopaedic surgeons, one musculoskeletal infectious disease specialist, and one health economics expert, was convened to evaluate the use of barbed sutures and skin adhesives for wound closure in hip and knee arthroplasty. Two systematic reviews informed the development of questionnaires, with panelists ranking their agreement on statements using a 5-point Likert scale. Consensus was achieved if ≥75% agreement. Unresolved statements were revisited in a second round.
Results: Consensus was reached on 11 statements, providing evidence-based recommendations. The expert panel advocates for a multilayer watertight technique using barbed sutures to prevent surgical site infections (SSI), reduce complications, shorten surgical times, optimise resources and improve cosmetic appearance. For skin closure, the panel recommends topical adhesives to decrease wound dehiscence, enhance cosmetic appearance, promote patient compliance, prevent SSIs, and optimise resources.
Conclusion: The Delphi consensus by Italian total joint arthroplasty experts underscores the pivotal role of barbed sutures and skin adhesives in optimising outcomes. While guiding clinical decision-making, these recommendations are not prescriptive and should be adapted to local practices. The study encourages further research to enhance current evidence.
Level of Evidence: Level III.
(© 2024 The Authors. Knee Surgery, Sports Traumatology, Arthroscopy published by John Wiley & Sons Ltd on behalf of European Society of Sports Traumatology, Knee Surgery and Arthroscopy.)
Databáze: MEDLINE
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