Adding glue to the surgical site after surgery for lower-extremity fractures.

INTRODUCTION

Surgical site infection is a concern after lower-extremity fracture surgery, and post-operative wound oozing may increase this risk. Applying glue to the incision could reduce oozing and thereby reduce the need for adhesive patch (AP) changes. This study compared AP change rates in adults with surgically treated lower-extremity fractures with and without the addition of wound glue.

METHODS

In this prospective cohort study, lower-extremity fractures treated surgically with implants were included, while external fixation and in-hospital deaths were excluded. Patients were enrolled over four months: two as controls and two with glue added to the wound. The primary outcome was AP change on all surgical wounds; secondary outcomes were AP change by fracture location, wound closure method and incision length (small: screw/nail; large: arthroplasty/plate). Follow-up continued throughout admission.

RESULTS

Among 339 patients, 162 received no glue and 177 received glue. The median age was 76 years, 55% were female and femoral fractures predominated. Groups were comparable at baseline. AP change occurred in 44% without glue and 35% with glue (p = 0.097). For large incisions, AP change was 42% without glue versus 27% with glue (p = 0.040). No differences were found by fracture location, surgery type or closure method.

CONCLUSIONS

Adding glue showed no significant overall reduction in AP changes. However, in large incisions, glue reduced AP changes by 15 percentage points, suggesting a benefit in this subgroup.

FUNDING: None.

TRIAL REGISTRATION: Not relevant.