The use of 2-octyl cyanoacrylate as an adjuvant to wound closure in total knee arthroplasty

Purpose The efficacy of the use of 2-octyl cyanoacrylate (OCA) as an adjuvant to wound closure in preventing wound complications after total knee arthroplasty (TKA) is rarely reported. This study was aimed to determine whether the use of OCA as a supplement to conventional wound closure reduces the incidence of wound complications following TKA. Patients and methods This retrospective study reviewed 1106 consecutive patients who underwent TKA for symptomatic end-stage osteoarthritis (OA) between 2012 and 2017. The first 562 patients who did not receive OCA were grouped into the Control group, and the subsequent 544 patients who received OCA as an adjuvant to wound closure were grouped into the OCA group. All patients were followed up for at least 2 years. The main outcome was the development of operative site complications, including aseptic and infectious complications. Aseptic wound complications were wound leakage, hematoma, wound dehiscence and delayed wound healing, and infectious complication was mainly referred to the superficial infection. Results No significant difference with regard to hematoma was observed between groups (3.0% vs. 3.7%, P = 0.617, phi = - 0.02). The incidences were significantly higher in the Control group versus the OCA group in regard to wound leakage (9.4% vs. 2.0%, P = 0.000, phi = 0.16), wound dehiscence (5.7% vs. 1.3%, P = 0.000, phi = 0.12), delayed wound healing (4.4% vs. 1.5%, P = 0.004, phi = 0.09) and superficial infection (2.0% vs. 0.4%, P = 0.022, phi = 0.07). No serious adverse events (AEs) occurred. Conclusions The present study showed that the addition of OCA reduced the incidence of wound leakage, wound dehiscence, delayed wound healing and superficial infection after TKA compared to conventional wound closure. Based on the outcomes above, we decide to use OCA routinely for wound closure after TKA.