Tissue Adhesive for Wound Closure in enhanced-recovery Total Hip Arthroplasty: A Prospective, Randomized and Controlled Study

Background: We aimed to present our experience of adopting tissue adhesive as adjunct to standard wound closure in total hip arthroplasty (THA) and evaluate its performance. Methods: From September 2019 to November 2019, we prospectively enrolled consecutive patients who underwent simultaneous bilateral THA in this randomized and controlled study. Standard wound closure was applied on one side of hip while additional tissue adhesive was applied on the other side at random. We collected and analyzed patients’ information, including age, gender, body mass index (BMI), diagnosis, postoperative length of stay (LOS), dressing changes, wound evaluation scores, wound-related cost and complications. Results: Thirty patients with simultaneous bilateral THA were enrolled in this study. During the hospital stay, the times of dressing change in hips with tissue adhesive was significantly less than that in the other hips (p=0.000). However, the wound-related cost in hips with tissue adhesive was significantly higher (p=0.000). According to patients’ feedback at one-month follow-up, wound evaluation of hips with tissue adhesive was significantly better than the other hips (p=0.004). Seventeen patients preferred tissue adhesive and only five patients preferred standard wound closure. Conclusions : Tissue adhesive could significantly reduce wound drainage and increase patients’ satisfaction, which can be an ideal adjunct to standard wound closure in enhanced-recovery THA.