Skin adhesive as an adjunct in total joint arthroplasty; a retrospective cohort study
Background: Surgical site infection (SSI) after lower limb total joint arthroplasty (TJA) is a complication that is associated with increased morbidity and mortality. A retrospective study was carried out to compare standard wound closure with and without skin adhesive. Method: The wound surveillance data of 408 patients who underwent either a hip or knee arthroplasty between 1st March 2016 and 31st October 2018 inclusive were retrospectively reviewed at our institution, a big tertiary teaching hospital at Salford Royal Hospital (Manchester, United Kingdom). The patients had undergone a primary elective lower limb arthroplasty. These patients were selected from the Sunrise electronic patient records (EPR). Inclusion criteria was more than 18 years of age. Results: 34 patients were diagnosed with a SSI (8.33%). Exact Fisher test showed that there is a statistical difference in the incidence of SSI after lower limb TJA when skin adhesive is used (p= 0.0016). The 2 cohorts of patients (skin adhesive cohort versus non-skin adhesive cohort) were not statistically different (p>0.05) in terms of age, BMI and duration of surgery. Conclusion: The incidence of SSI was found to be very high compared to the incidence reported in the literature. The high statistical significance shows that the use of skin adhesive in wound closure considerably reduces SSI and therefore, its use should be recommended.