General Assembly, Prevention, Wound Management: Proceedings of International Consensus on Orthopedic Infections.
(2019) Journal of Arthroplasty — Vol. 34, n° 2 Suppl, p. S157-S168 (2019)
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- (en) Question 1: Does the type of wound closure (technique and material) affect the incidence of subsequent SSI/PJI? Recommendation: There is a lack of strong evidence clearly demonstrating the superiority of any wound closure method after total joint arthroplasty (TJA). The majority of the high-quality studies demonstrate no difference between the various types of wound closure. Level of Evidence: Moderate Delegate Vote: Agree: 90%, Disagree: 8%, Abstain: 2% (Super Majority, Strong Consensus) Rationale: Currently there are several techniques available for wound closure after total joint arthroplasty which include staples, sutures, adhesives, and transdermal systems [1]. Although several randomized clinical trials (RCTs) are available, surgeons primarily select wound closure systems based on personal preference. The ultimate goal is to use a wound closure system that balances cosmetic appearance, clinical outcomes, and cost-effectiveness. Based on the currently available literature, no closure system has been shown to consistently reduce the risk of surgical site infection/periprosthetic joint infection. Despite several level I evidence studies investigating the complications of wound closure systems, they are dramatically underpowered. A summary of the available literature on each method of wound closure is discussed in the following sections. [...]
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Al-Houraibi, R. K., Aalirezaie, A., Adib, F., Anoushiravani, A., Bhashyam, A., Binlaksar, R., Blevins, K., Bonanzinga, T., Chih-Kuo, F., Cordova, M., Deirmengian, G. K., Fillingham, Y., Frenkel, T., Gomez, J., Gundtoft, P., Harris, M. A., Harris, M., Heller, S., Jennings, J. A., et al. (2019). General Assembly, Prevention, Wound Management: Proceedings of International Consensus on Orthopedic Infections. Journal of Arthroplasty, 34(2 Suppl), S157-S168. https://doi.org/10.1016/j.arth.2018.09.066 (Original work published 2019)