Polyester Mesh Dressings Reduce Delayed Wound Healing and Reoperations Compared with Silver-Impregnated Occlusive Dressings after Knee Arthroplasty
Background: New dressings aimed at reducing surgical wound complications after knee arthroplasty continue to evolve. We compared wound complications and reoperations between 2 dressings: 2-octyl cyanoacrylate adhesive and polyester mesh (Dermabond® Prineo®, “mesh”) and silver-impregnated occlusive d...
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| Format: | Article |
| Language: | English |
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Elsevier
2020-09-01
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| Series: | Arthroplasty Today |
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| Online Access: | http://www.sciencedirect.com/science/article/pii/S2352344120300856 |
| _version_ | 1818148072369160192 |
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| author | Forrest L. Anderson, MD Carl L. Herndon, MD Akshay Lakra, BSc, MBBS, MS Jeffrey A. Geller, MD H. John Cooper, MD Roshan P. Shah, MD, JD |
| author_facet | Forrest L. Anderson, MD Carl L. Herndon, MD Akshay Lakra, BSc, MBBS, MS Jeffrey A. Geller, MD H. John Cooper, MD Roshan P. Shah, MD, JD |
| author_sort | Forrest L. Anderson, MD |
| collection | DOAJ |
| description | Background: New dressings aimed at reducing surgical wound complications after knee arthroplasty continue to evolve. We compared wound complications and reoperations between 2 dressings: 2-octyl cyanoacrylate adhesive and polyester mesh (Dermabond® Prineo®, “mesh”) and silver-impregnated occlusive dressings and n-butyl-2-cyancacrylate adhesive (AQUACEL® Ag SURGICAL cover dressing with SwiftSet™, “standard''). Methods: This retrospective cohort study reviewed 353 consecutive partial and total knee arthroplasties performed by a single surgeon; 6 were excluded for not using either dressing type. Thus, 347 cases were separated into 2 cohorts: mesh (n = 176) and standard dressing (n = 171). Demographics and risk factors were similar, except for age. Surgical and closure techniques were consistent in all patients. Delayed wound healing was assessed by the surgeon at the 2-week office visit for drainage, suture abscess, or wound edge separation. Secondary outcome measures include infection, office-based closure, and return to the operating room for reclosure. Results: There were 2 instances of delayed wound healing in the mesh group and 16 in the standard dressing group (1.14% vs 9.36%, P ≤ .0001). There were significantly fewer reoperations in the mesh group than in the standard group (0 vs 2.33%, P = .04). There were no infections or office-based closures. Conclusions: Mesh dressings were associated with fewer episodes of delayed wound healing and reoperations than the standard dressing. A possible mechanism may be that this brand of mesh distributes wound tension more evenly. In addition, because it remains in place longer during the immediate postoperative period, it may work via prolonged wound edge support. |
| first_indexed | 2024-12-11T12:45:20Z |
| format | Article |
| id | doaj.art-2b9db73e6eb044ceb21c6bc2225bc254 |
| institution | Directory Open Access Journal |
| issn | 2352-3441 |
| language | English |
| last_indexed | 2024-12-11T12:45:20Z |
| publishDate | 2020-09-01 |
| publisher | Elsevier |
| record_format | Article |
| series | Arthroplasty Today |
| spelling | doaj.art-2b9db73e6eb044ceb21c6bc2225bc2542022-12-22T01:06:50ZengElsevierArthroplasty Today2352-34412020-09-0163350353Polyester Mesh Dressings Reduce Delayed Wound Healing and Reoperations Compared with Silver-Impregnated Occlusive Dressings after Knee ArthroplastyForrest L. Anderson, MD0Carl L. Herndon, MD1Akshay Lakra, BSc, MBBS, MS2Jeffrey A. Geller, MD3H. John Cooper, MD4Roshan P. Shah, MD, JD5Center for Hip and Knee Replacement, Department of Orthopedic Surgery, Columbia University Irving Medical Center, New York, NY, USACenter for Hip and Knee Replacement, Department of Orthopedic Surgery, Columbia University Irving Medical Center, New York, NY, USACenter for Hip and Knee Replacement, Department of Orthopedic Surgery, Columbia University Irving Medical Center, New York, NY, USACenter for Hip and Knee Replacement, Department of Orthopedic Surgery, Columbia University Irving Medical Center, New York, NY, USACenter for Hip and Knee Replacement, Department of Orthopedic Surgery, Columbia University Irving Medical Center, New York, NY, USACorresponding author. Center for Hip and Knee Replacement, Department of Orthopedic Surgery, Columbia University Irving Medical Center, 622 West 168th Street PH 1138, New York, NY 10032, USA. Tel.: +1-212-305-5974.; Center for Hip and Knee Replacement, Department of Orthopedic Surgery, Columbia University Irving Medical Center, New York, NY, USABackground: New dressings aimed at reducing surgical wound complications after knee arthroplasty continue to evolve. We compared wound complications and reoperations between 2 dressings: 2-octyl cyanoacrylate adhesive and polyester mesh (Dermabond® Prineo®, “mesh”) and silver-impregnated occlusive dressings and n-butyl-2-cyancacrylate adhesive (AQUACEL® Ag SURGICAL cover dressing with SwiftSet™, “standard''). Methods: This retrospective cohort study reviewed 353 consecutive partial and total knee arthroplasties performed by a single surgeon; 6 were excluded for not using either dressing type. Thus, 347 cases were separated into 2 cohorts: mesh (n = 176) and standard dressing (n = 171). Demographics and risk factors were similar, except for age. Surgical and closure techniques were consistent in all patients. Delayed wound healing was assessed by the surgeon at the 2-week office visit for drainage, suture abscess, or wound edge separation. Secondary outcome measures include infection, office-based closure, and return to the operating room for reclosure. Results: There were 2 instances of delayed wound healing in the mesh group and 16 in the standard dressing group (1.14% vs 9.36%, P ≤ .0001). There were significantly fewer reoperations in the mesh group than in the standard group (0 vs 2.33%, P = .04). There were no infections or office-based closures. Conclusions: Mesh dressings were associated with fewer episodes of delayed wound healing and reoperations than the standard dressing. A possible mechanism may be that this brand of mesh distributes wound tension more evenly. In addition, because it remains in place longer during the immediate postoperative period, it may work via prolonged wound edge support.http://www.sciencedirect.com/science/article/pii/S2352344120300856Total knee arthroplastyUnicondylar knee arthroplastyWound healing complicationsDressings |
| spellingShingle | Forrest L. Anderson, MD Carl L. Herndon, MD Akshay Lakra, BSc, MBBS, MS Jeffrey A. Geller, MD H. John Cooper, MD Roshan P. Shah, MD, JD Polyester Mesh Dressings Reduce Delayed Wound Healing and Reoperations Compared with Silver-Impregnated Occlusive Dressings after Knee Arthroplasty Arthroplasty Today Total knee arthroplasty Unicondylar knee arthroplasty Wound healing complications Dressings |
| title | Polyester Mesh Dressings Reduce Delayed Wound Healing and Reoperations Compared with Silver-Impregnated Occlusive Dressings after Knee Arthroplasty |
| title_full | Polyester Mesh Dressings Reduce Delayed Wound Healing and Reoperations Compared with Silver-Impregnated Occlusive Dressings after Knee Arthroplasty |
| title_fullStr | Polyester Mesh Dressings Reduce Delayed Wound Healing and Reoperations Compared with Silver-Impregnated Occlusive Dressings after Knee Arthroplasty |
| title_full_unstemmed | Polyester Mesh Dressings Reduce Delayed Wound Healing and Reoperations Compared with Silver-Impregnated Occlusive Dressings after Knee Arthroplasty |
| title_short | Polyester Mesh Dressings Reduce Delayed Wound Healing and Reoperations Compared with Silver-Impregnated Occlusive Dressings after Knee Arthroplasty |
| title_sort | polyester mesh dressings reduce delayed wound healing and reoperations compared with silver impregnated occlusive dressings after knee arthroplasty |
| topic | Total knee arthroplasty Unicondylar knee arthroplasty Wound healing complications Dressings |
| url | http://www.sciencedirect.com/science/article/pii/S2352344120300856 |
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