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A550. IMPROVING OPERATING ROOM EFFICIENCY BY MODERNIZING WOUND CLOSURE IN TOTAL KNEE ARTHROPLASTY



Abstract

Introduction: Wound Hemearthrosis remains a major concern following TKA. This prospective study evaluates the use of a knotless interlocking suture system and its relationship to wound appearance and OR efficiency.

Methods: Two groups of patients undergoing TKA in our institution were evaluated using two different wound closure techniques. Group I consisted of twenty five patients who underwent standard closure using interrupted vicryl for the arthrotomy, deep fascia, superficial fascia, followed by staples. Group II consisted of twenty five patients who underwent closure using three separate running barbed sutures (Quill, Angiotech Inc)– first for the arthrotomy, followed by deep fascia, subcuticular and staples. We compared closure times, drain output and postoperative day to achieve zero wound drainage on the dressings.

Results: Closure times for Group II averaged 10 minutes faster than Group I. Drain output was decreased in the barbed suture cohort. Wounds achieved zero drainage, on average, one day sooner in Group II and no patients were returned to the OR for hematoma evacuation or arthrotomy disruption.

Conclusions: Use of this new technique for closure of TKA incisions can lead to faster operative times, lower drainage outputs and less immediate postoperative wound drainage. It appears that hemostasis is obtained quicker with the use of this barbed suture system while at the same time while maximizing OR efficiency.

Correspondence should be addressed to Diane Przepiorski at ISTA, PO Box 6564, Auburn, CA 95604, USA. Phone: +1 916-454-9884; Fax: +1 916-454-9882; E-mail: ista@pacbell.net