Literature DB >> 35669029

Retention Stitches: A Concept of Wound Closure of Knee Arthroplasty in Obese Patients.

Amyn M Rajani1, C J Thakkar1, Urvil A Shah1, Meenakshi Punamiya1.   

Abstract

Background: Knee joint arthroplasty is a commonly performed procedure. However, number of obese patients undergoing total knee arthroplasty is on a rise. In such cases, post closure using routine techniques, there have been an increasing number of cases of wound dehiscence and complications like persistent discharge and delayed healing. To overcome this problem, the author has come up with an innovative technique in closure. Materials and
Methods: 27 patients, who were obese, were included in the study and operated at Orthopaedic Arthroscopic Knee and Shoulder clinic. The patients were evaluated pre operatively clinically and planned for retention stitches for closure. Same technique was followed for closure in all the patients. Suture removal was done at 2 weeks and patients were followed up for a period of 6 months for any complications.
Results: In 27 patients undergoing retention stitches post total knee arthroplasty, patients were followed up for a mean period of 14 months, with minimum being 6 months and maximum being 5 years. Patients showed no complications such as wound dehiscence, discharge, localised skin necrosis or cut-through of stitches.
Conclusion: Retention stitches in knee arthroplasty is an innovative, ideal, yet easily replicable method of wound closure in obese patients, especially with BMI > 30 (Obesity grade 1 or more). Patients undergo better and uneventful wound healing, which is of paramount importance in a surgery like this. In all these patients, the rehabilitation post surgery is also similar to the other patients, hence not affecting the outcome. Supplementary Information: The online version contains supplementary material available at 10.1007/s43465-021-00596-y. © Indian Orthopaedics Association 2021.

Entities:  

Keywords:  Morbidly obese; Offloading; Retention stitches; TKR; Wound closure; Wound dehiscence

Year:  2022        PMID: 35669029      PMCID: PMC9123118          DOI: 10.1007/s43465-021-00596-y

Source DB:  PubMed          Journal:  Indian J Orthop        ISSN: 0019-5413            Impact factor:   1.033


  6 in total

1.  Total knee arthroplasty in morbidly obese patients.

Authors:  R Winiarsky; P Barth; P Lotke
Journal:  J Bone Joint Surg Am       Date:  1998-12       Impact factor: 5.284

2.  Negative side-effects of retention sutures for abdominal wound closure. A prospective randomised study.

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Journal:  Eur J Surg       Date:  2000-12

3.  Obesity increases the likelihood of total joint replacement surgery among younger adults.

Authors:  S Harms; R Larson; A E Sahmoun; J R Beal
Journal:  Int Orthop       Date:  2006-05-11       Impact factor: 3.075

4.  The impact of body mass index on later total hip arthroplasty for primary osteoarthritis: a cohort study in 1.2 million persons.

Authors:  Gunnar B Flugsrud; Lars Nordsletten; Birgitte Espehaug; Leif I Havelin; Anders Engeland; Haakon E Meyer
Journal:  Arthritis Rheum       Date:  2006-03

5.  Abdominal wound dehiscence in gastroenterological surgery.

Authors:  F M Penninckx; S V Poelmans; R P Kerremans; J P Beckers
Journal:  Ann Surg       Date:  1979-03       Impact factor: 12.969

6.  The obesity epidemic: its effect on total joint arthroplasty.

Authors:  Thomas K Fehring; Susan M Odum; William L Griffin; J Bohannon Mason; Thomas H McCoy
Journal:  J Arthroplasty       Date:  2007-07-26       Impact factor: 4.757

  6 in total

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