TY - JOUR
T1 - Identifying Critical Evidence Gaps in Wound Closure and Incision Management After Total Knee Arthroplasty
T2 - Delphi Panel Insights
AU - Ainslie-Garcia, Margaret H.
AU - Anderson, Lucas A.
AU - Bloch, Benjamin V.
AU - Board, Tim N.
AU - Chen, Antonia F.
AU - Craigie, Samantha
AU - Danker, Walter
AU - Gunja, Najmuddin
AU - Harty, James
AU - Hernandez, Victor H.
AU - Lebedeva, Kate
AU - Hameed, Daniel
AU - Mont, Michael A.
AU - Nunley, Ryan M.
AU - Parvizi, Javad
AU - Perka, Carsten
AU - Piuzzi, Nicolas S.
AU - Rolfson, Ola
AU - Rychlik, Joshua
AU - Romanini, Emilio
AU - Sanz-Ruiz, Pablo
AU - Sierra, Rafael J.
AU - Suleiman, Linda
AU - Tsiridis, Eleftherios
AU - Vendittoli, Pascal André
AU - Wangen, Helge
AU - Zagra, Luigi
N1 - Publisher Copyright:
© 2024 Elsevier Inc.
PY - 2025/1
Y1 - 2025/1
N2 - Background: Effective surgical wound management in total knee arthroplasty (TKA) is crucial for optimal healing and patient outcomes. Despite surgical advances, managing wounds to prevent complications remains challenging. This study aimed to identify and address evidence gaps in TKA wound management, including preoperative optimization, intraoperative options, and postoperative complication avoidance. Addressing these issues is vital for patient recovery and surgical success. Methods: This study used the Delphi method with 20 experienced orthopedic surgeons from Europe and North America. Conducted from April to September 2023, the process involved three stages: an initial electronic survey, a virtual meeting, and a concluding electronic survey. The panel reviewed and reached a consensus on 26 statements about TKA wound management based on a comprehensive literature review. Additionally, the panel aimed to identify critical evidence gaps in wound management practices. Results: The panel achieved consensus on various wound management practices but highlighted significant evidence gaps. Consensus was reached on wound closure methods, including mesh-adhesive dressings, skin glue, staples, barbed sutures, and negative pressure wound therapy. However, further evidence is needed to address the cost-effectiveness of these methods and develop best practices for patient outcomes. Identifying these gaps highlights the need for more research to improve TKA wound care. Conclusions: Identifying major evidence gaps underscores the need for targeted research in TKA wound management. Addressing these gaps is crucial for developing effective, efficient, and patient-friendly wound care strategies. Future research should focus on comparative effectiveness studies and developing guidelines for emerging technologies. Bridging these gaps could improve patient outcomes, reduce complications, and enhance TKA surgery success.
AB - Background: Effective surgical wound management in total knee arthroplasty (TKA) is crucial for optimal healing and patient outcomes. Despite surgical advances, managing wounds to prevent complications remains challenging. This study aimed to identify and address evidence gaps in TKA wound management, including preoperative optimization, intraoperative options, and postoperative complication avoidance. Addressing these issues is vital for patient recovery and surgical success. Methods: This study used the Delphi method with 20 experienced orthopedic surgeons from Europe and North America. Conducted from April to September 2023, the process involved three stages: an initial electronic survey, a virtual meeting, and a concluding electronic survey. The panel reviewed and reached a consensus on 26 statements about TKA wound management based on a comprehensive literature review. Additionally, the panel aimed to identify critical evidence gaps in wound management practices. Results: The panel achieved consensus on various wound management practices but highlighted significant evidence gaps. Consensus was reached on wound closure methods, including mesh-adhesive dressings, skin glue, staples, barbed sutures, and negative pressure wound therapy. However, further evidence is needed to address the cost-effectiveness of these methods and develop best practices for patient outcomes. Identifying these gaps highlights the need for more research to improve TKA wound care. Conclusions: Identifying major evidence gaps underscores the need for targeted research in TKA wound management. Addressing these gaps is crucial for developing effective, efficient, and patient-friendly wound care strategies. Future research should focus on comparative effectiveness studies and developing guidelines for emerging technologies. Bridging these gaps could improve patient outcomes, reduce complications, and enhance TKA surgery success.
KW - Delphi method
KW - evidence gaps
KW - postoperative complications
KW - surgical wound closure
KW - total knee arthroplasty (TKA)
KW - wound management
UR - http://www.scopus.com/inward/record.url?scp=85200734186&partnerID=8YFLogxK
U2 - 10.1016/j.arth.2024.06.057
DO - 10.1016/j.arth.2024.06.057
M3 - Article
C2 - 38972434
AN - SCOPUS:85200734186
SN - 0883-5403
VL - 40
SP - 111-118.e1
JO - Journal of Arthroplasty
JF - Journal of Arthroplasty
IS - 1
ER -