Incision healing and time to weightbearing with and without use of adhesive retention suture device in total ankle arthroplasty.

Abstract

Total ankle arthroplasty (TAA) is a useful treatment for ankle arthritis. A common complication however is incisional dehiscence. Adhesive suture retention devices (ASRDs) can assist with closure of surgical and traumatic wounds under tension. This retrospective comparative study evaluates the use of ASRDs on TAA patients' incision healing time and time to full weightbearing. Fifty TAA patients between 2021 and 2023 were divided equally into 2 groups. Demographics included age, BMI, implant, comorbidities and complications. Results included healing time of the incision, time to full weightbearing, and incision length (cm). Preoperative and postoperative AOFAS, FFI, and VAS scores were also recorded. Mean follow-up for the group without ASRDs was 27.7 months, and 24.3 months in the group with ASRDs. Mean incision healing time and return to weightbearing was 37.1 days (Range 28-44 days; SD 4.65) in the group without ASRDs, with average incision length 9.1 cm (Range 5-14 cm; SD 2.00). Mean healing time was 19.9 days (Range 16-27 days; SD 3.29), with average incision length 7.4 cm (Range 6-9 cm; SD 0.76), in the group with ASRDs. This shows a statistically-significant decrease in incision length (p = 0.0065) and return to weightbearing (p < 0.001) in the ASRD group. There was statistically-significant improvement of postoperative AOFAS (p < 0.001; p < 0.001 VAS (p < 0.001; p < 0.001), and FFI (p < 0.001; p < 0.001) scores when compared to preoperative values within either group, no ASRD and ASRD, respectively. Utilization of ASRDs on TAA incisions can greatly decrease time to full weightbearing and incision healing time.