Skin adhesive as an adjunct in primary total joint arthroplasty of the lower limb: A retrospective cohort study

Abstract

Background: Surgical site infection (SSI) after lower-limb total joint arthroplasty is a complication that is associated with increased morbidity and mortality. Numerous risk factors are known to be linked to SSI. Patients and Methods: The wound surveillance data of 408 patients who underwent either a hip or knee arthroplasty between March 1, 2016, and October 31, 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. Inclusion criteria were more than 18 years of age. Results: Four hundred and eight patients were included in the study. The rate of SSI was 8.3% (34 patients). Body mass index (P = 0.00948) and use of skin adhesive (P = 0.0016) were associated with SSI. There were also some notable absences such as diabetes mellitus, use of immunosuppressive medication, wound leakage <48 h, and hypertension. 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.