A Comparative Study of Incision Closure Methods for Total Knee Replacement
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Purpose
The aim of the study is to compare incision closure techniques for total knee replacement using a combination of state-of-the-art sutures with tissue adhesives or staples in an effort to identify the best approach with respect to time efficiency, cost, durability, dehiscence, microbial resistance and cosmesis.
The hypothesis is that the combined suture/adhesive approach (sutures for capsule and subcutaneous layers, and tissue adhesive for the final cutaneous layer) or suture/staple approach will be significantly faster and of comparable durability as the conventional exclusive suture approach (sutures used for the capsule, subcutaneous, and cutaneous layers). This is a prospective, randomized, controlled, single site, unblinded (open label) study.
| Condition | Intervention |
|---|---|
|
Total Knee Replacement Closure Wound Closure |
Device: Histoacryl Tissue Adhesive Device: Dermabond Device: Staples Device: Monocryl 4-0 |
| Study Type: | Interventional |
| Study Design: | Allocation: Randomized Endpoint Classification: Efficacy Study Intervention Model: Single Group Assignment Masking: Open Label Primary Purpose: Treatment |
| Official Title: | A Comparative Study of Incision Closure Methods for Total Knee Arthroplasty |
- Primary Outcome Measure [ Time Frame: 1/2009-10/2009 ] [ Designated as safety issue: No ]The primary endpoint is the mean procedure time improvement for TKA incision closure using a combined suture/adhesive or suture/staple approach versus suture closure alone.
- Mean postop hospital stay [ Time Frame: 1/2009-10/2009 ] [ Designated as safety issue: No ]Change in mean postop hospital stay between study and control cohorts
| Enrollment: | 75 |
| Study Start Date: | January 2009 |
| Study Completion Date: | October 2009 |
| Primary Completion Date: | August 2009 (Final data collection date for primary outcome measure) |
| Arms | Assigned Interventions |
|---|---|
|
Active Comparator: Histoacryl Tissue Adhesive
Histoacryl Blue (HAB) Tissue Adhesive (n-butyl-2 cyanoacrylate; B. Braun Corp., Melsungen, Germany). Histocryl is a FDA-approved sterile liquid skin adhesive that has been utilized as a substitute for sutures for wound closure for approximately 40 years.
|
Device: Histoacryl Tissue Adhesive |
|
Active Comparator: Dermabond
Dermabond High Viscosity Tissue Adhesive (2-ocytl cyanoacrylate; Ethicon, Somerville, NJ). Dermabond is also a FDA-approved liquid bonding agent that has been utilized for wound closure for approximately 10 years and proven as effective as sutures.
|
Device: Dermabond |
|
Active Comparator: Staples
Visistat 35W Stapler (Teleflex Corp, Limerick, PA). The FDA-approved Weck staple system with stainless steel staples has been proven over years of use and remains the standard accepted closure approach due to speed of insertion as well as removal.
|
Device: Staples |
|
Active Comparator: Running Subcuticular with Monocryl
Monocryl 4-0 Suture (Ethicon, Somerville, NJ). Monocryl is an FDA-approved absorbable, synthetic, suture indicated for soft tissue approximation.
|
Device: Monocryl 4-0 |
Eligibility| Ages Eligible for Study: | 21 Years and older |
| Genders Eligible for Study: | Both |
| Accepts Healthy Volunteers: | Yes |
Inclusion Criteria:
- Inclusion criteria included 18 years or older
- TKA scheduled without a bilateral planned within one week of the initial surgery
- Willingness to attend prescribed physical therapy 3 times per week.
Exclusion Criteria:
- Exclusion criteria included medical conditions or personal circumstances that would prevent participation and completion of physical therapy and follow-up visits
- Current participation in another clinical trial
- Preoperative systemic infections
- Uncontrolled diabetes, or diseases or conditions known to effect the wound healing process
- Known hypersensitivity to cyanoacrylate
- Formaldehyde, or the dye D&C Violet #2
- Prior knee hardware fixation devices
- Prior knee incisions greater than 9cm, and arthrofibrosis as evidence by limited ROM less than 80°.
Contacts and Locations
More Information
No publications provided
| Responsible Party: | Foundation for Southwest Orthopedic Research |
| ClinicalTrials.gov Identifier: | NCT01088074 History of Changes |
| Other Study ID Numbers: | IRB1108-0328 |
| Study First Received: | March 16, 2010 |
| Last Updated: | August 21, 2012 |
| Health Authority: | United States: Food and Drug Administration |
Keywords provided by Foundation for Southwest Orthopedic Research:
|
Total Knee Replacement Closure Methods |
ClinicalTrials.gov processed this record on June 18, 2013