The Use of New Technology for Wound Management Following Total Knee Arthroplasty: Implications for the COVID-19 Crisis.

ABSTRACT

With constantly evolving materials and techniques used in wound closure management for total knee arthroplasty (TKA), it is imperative that we continuously evaluate new modalities and techniques to optimize healing. This article provides a concise review of the current closure and wound management methods for each of the following three layers and dressing 1) deep fascia layer, or arthrotomy; 2) subdermal layer or subcutaneous layer; 3) skin and subcuticular layer; and 4) dressing application. By introducing a comprehensive and systematic approach to TKA wounds, this report also incorporates newer modalities such as barbed sutures and adhesive dressings, which have increasingly replaced traditional suture and staple methods. Furthermore, we examine how various layers of modern wound closure compare to conventional methods while discussing both the clinical and economic impacts of each. Newer wound management methods, such as the adhesive and occlusive dressings with varying monofilament subcuticular sutures, can eliminate the need for staple and suture removal, increase the value of care provided, limit unnecessary postoperative visits, and potentially address wound issues by communicating safely with patients via telemedicine, an ever-relevant discussion in the era of coronavirus disease 2019 (COVID-19).