A Comparison of 2-octyl Cyanoacrylate Skin Adhesive and Polyester Mesh for Wound Closure in Total Knee Arthroplasty, A Randomized Controlled Study

OsteoArthritis Knee Clinical Trial

Official title:

A Comparison of 2-octyl Cyanoacrylate Skin Adhesive and Polyester Mesh for Wound Closure in Total Knee Arthroplasty, A Randomized Controlled Study

Clinical Trial Details — Status: Active, not recruiting

Administrative data

• NCT number: NCT06232018
• Other study ID #: HYH EC 059-66-01
• Status: Active, not recruiting
• Phase: N/A
• Start date: September 28, 2023
• Est. completion date: December 1, 2024

Study information

• Verified date: June 2024
• Source: HatYai Hospital
• Contact: n/a
• Is FDA regulated: No
• Study type: Interventional

Clinical Trial Summary

The goal of this randomized controlled study is to investigate the Efficacy of Using skin adhesive (Dermabond) and skin adhesive with polyester mesh (Dermabond Prineo )for Wound Closure in Total Knee Arthroplasty, The main question it aim to answer

1 Are skin adhesive alone and with Polyester mesh in Total knee arthroplasty different in Patient satisfaction evaluated by POSAS score

Description:

Nowadays, there are many methods of wound closure in Total Knee arthroplasty, such as nylon, skin staple, and sterile strip, which differ in advantages and disadvantages of each technique. However, these methods have the same disadvantages: wound discharge, which may lead to infection, wound separation, and the need for wound dressing. It is also a burden for patients and caregivers. In travelling to change the wound in a hospital, There are many costs in terms of wound dressing equipment, travel costs and time off from work for caregivers to take patients to get wound dressing.

Skin adhesive is an innovation for wound closure in total knee arthroplasty. It reduces the problem of wound separation, with no need for wound dressing.

Skin adhesive mesh has been studied in many studies, showing that it can be used well. Strong It is no different from traditional wound closure; the scar is more beautiful. Patients are more satisfied. But the disadvantage is the high price.

Skin adhesive without polyester mesh has the advantage of being cheaper three times than polyester mesh but less intense than with mesh. This makes it unpopular.

No studies have been found comparing wound dressings with mesh and no mesh After knee replacement surgery.

Therefore, this study is to compare skin adhesive and skin adhesive plus polyester mesh in closure wound total knee arthroplasty.

Are there differences in patient satisfaction Are wound complications such as wound oozing, wound separation, superficial wound skin infection, and contact dermatitis different?

Recruitment information / eligibility

• Status: Active, not recruiting
• Enrollment: 80
• Est. completion date: December 1, 2024
• Est. primary completion date: September 28, 2024
• Accepts healthy volunteers: Accepts Healthy Volunteers
• Gender: All
• Age group: 50 Years to 80 Years

Eligibility

Inclusion Criteria:

• OA knee need for Total knee arthroplasty

• Age 50-80 years old

Exclusion Criteria:

• Previous surgery of knee

• History of Keloid, Scar, Psoriasis at the knee

• History of contact dermatitis with skin adhesive

• Cognitive impairment

Related Conditions & MeSH terms

• OsteoArthritis Knee
• Osteoarthritis, Knee

Intervention

Device:
• Skin adhesive (Dermabond)
Arthrotomy (deep layer) is repaired using number 1-0 monofilament absorbable suture (STRATAFIX™ , Ethicon, johnson & johnson, Somerville, NJ) Subcuticular suture is repaired using number 3-0 monofilament absorbable suture (STRATAFIX™ , Ethicon, johnson & johnson, Somerville, NJ) After subticular sutures was done 2-octylcyanoacrylate glue (DERMABOND ADVANCED®, Ethicon, johnson & johnson, Somerville, NJ) was applied
• skin adhesive + polyester mesh (Dermabond prineo)
Arthrotomy (deep layer) is repaired using number 1-0 monofilament absorbable suture (STRATAFIX™ , Ethicon, johnson & johnson, Somerville, NJ) Subcuticular suture is repaired using number 3-0 monofilament absorbable suture (STRATAFIX™ , Ethicon, johnson & johnson, Somerville, NJ) After subticular sutures was done 2-octylcyanoacrylate glue + polyester mesh ( DERMABOND PRINEO®, Ethicon, johnson & johnson, Somerville, NJ) was applied

Locations

Country	Name	City	State
Thailand	Pooriwat Lertsurawat	Songkhla

Sponsors (2)

Lead Sponsor	Collaborator
Pooriwat Lertsurawat	Kittipon Naratrikun

Country where clinical trial is conducted

Thailand, 

References & Publications (7)

Choi KY, Koh IJ, Kim MS, Park DC, Sung YG, In Y. 2-Octyl Cyanoacrylate Topical Adhesive as an Alternative to Subcuticular Suture for Skin Closure After Total Knee Arthroplasty: A Randomized Controlled Trial in the Same Patient. J Arthroplasty. 2021 Sep;36(9):3141-3147. doi: 10.1016/j.arth.2021.04.033. Epub 2021 May 3. — View Citation

El-Gazzar Y, Smith DC, Kim SJ, Hirsh DM, Blum Y, Cobelli M, Cohen HW. The use of dermabond(R) as an adjunct to wound closure after total knee arthroplasty: examining immediate post-operative wound drainage. J Arthroplasty. 2013 Apr;28(4):553-6. doi: 10.1016/j.arth.2012.07.038. Epub 2012 Oct 29. — View Citation

Gromov K, Troelsen A, Raaschou S, Sandhold H, Nielsen CS, Kehlet H, Husted H. Tissue Adhesive for Wound Closure Reduces Immediate Postoperative Wound Dressing Changes After Primary TKA: A Randomized Controlled Study in Simultaneous Bilateral TKA. Clin Orthop Relat Res. 2019 Sep;477(9):2032-2038. doi: 10.1097/CORR.0000000000000637. — View Citation

Khan RJ, Fick D, Yao F, Tang K, Hurworth M, Nivbrant B, Wood D. A comparison of three methods of wound closure following arthroplasty: a prospective, randomised, controlled trial. J Bone Joint Surg Br. 2006 Feb;88(2):238-42. doi: 10.1302/0301-620X.88B2.16923. — View Citation

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 Sep;32(9):2920-2927. doi: 10.1016/j.arth.2017.04.004. Epub 2017 Apr 12. — View Citation

Kong X, Yang M, Guo R, Chen J, Chai W, Wang Y. A Prospective, Randomized and Controlled Study on Tissue Adhesive for Skin Incision in Total Knee Arthroplasty. Ther Clin Risk Manag. 2020 Aug 24;16:795-802. doi: 10.2147/TCRM.S260007. eCollection 2020. — View Citation

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 Apr;30(3):447-453. doi: 10.1007/s00590-019-02591-4. Epub 2019 Nov 5. Erratum In: Eur J Orthop Surg Traumatol. 2020 Mar 31;: — View Citation

Outcome

Type	Measure	Description	Time frame	Safety issue
Primary	Patient observer scar assessment score (POSAS)	Evaluated Patient observer scar assessment score (POSAS); The POSAS is composed of two numerical scales that evaluate signs and symptoms of healing.; Consists of the two following parts: a scale for patients and a scale for observers.; Both contain six items punctuated numerically from 1 to 10; The lowest score is 1 and corresponds to the normal skin; The highest score is 10 and corresponds to the worst skin; The total score of both scales can be calculated simply by adding the scores of each of the six items.; The total score will range from 6 to 60.	6 weeks, 3 months
Secondary	Vancouver scar scale	Evaluated vancouver scar scale; Vancouver Scar Scale (VSS) is used for validated scar assessment tools; Consist of the four following parts : vascularity, height, pliability, and pigmentation; Each characteristic is given a score, which are added together to give an overall score between 0 and 13; The lowest score is 0 and corresponds to the normal skin.; The highest score is 10 and corresponds to the worst skin.	6weeks, 3 months
Secondary	Wound complication	Evaluated wound complication ( Wound dehiscence Superficial wound infection Allergic contact dermatitis); Outcome Measure reported as number of patients had developed wound complication within 3 months follow up and calculated proportion of wound complication in percentage	Within 3 months
Secondary	Wound drainage	Evaluated by Count table of blood strike on Water proof dressing; Outcome Measure by Count number of blood strike on water proof dressing by put the water proof dressing on the table grid square millimeter and count blood strike Reported as Number of blood strike as square millimeter	2 weeks