DOS 2020

8 · DOS Abstracts Occlusive Wound Closure Prevents Prolonged Wound Discharge - A Randomized Controlled Trial In Patients Undergoing Tumor Resection And Endoprosthetic Reconstruction Of The Proximal Femur - Werner Hettwer, Chunsen Wu, Peter Horstmann, Claus Lindkær Jensen, Anders Krarup-Hansen, Michael Mørk Petersen Orthopaedic Surgery, Rigshospitalet; Institute of Clinical Research, University of Southern Denmark; Department of Oncology, Herlev Gentofte Hospital Background: This study examined the effect of an occlusive wound closure product (Dermabond Prineo-22 skin closure system (Ethicon, Somerville, NJ, USA)) in a patient population at high risk for prolonged wound discharge and found that it significantly reduced frequency, degree and duration of this com- plication in comparison to conventional skin staples. Purpose / Aim of Study: Prolonged wound discharge (PWD) is a common post-operative complication of orthopaedic procedures and a risk factor for implant-related infection. Occlusive wound closure (OWC) methods have pre- viously been suggested to reduce or even prevent this complication. However, conclusive evidence in support of this hypothesis is still lacking. Materials and Methods: We performed a randomized controlled trial on 70 patients who underwent surgical treatment for metastatic- or malignant he- matologic bone disease involving the proximal femur at our center between January 2017 and August 2018. At conclusion of the tumor resection and endo-prosthetic reconstruction procedure, patients were randomized to either OWC (n=35), using the Dermabond Prineo-22 skin closure system, or routine wound closure with conventional skin staples (n=35). Findings / Results: Skin closure with OWC resulted in a significantly lesser de- gree (p<0.0001) and shorter duration of post-operative wound discharge (HR 2.89 [95% CI 1.6-5.05], p<0.0018). Compared to staples, surgical wounds were already dry after a mean of 3.5 days (vs 6.1 days, [95%CI 3.2-3.9 vs. 4.8-7.3], p<0.0001). PWD for 7 days or more was observed in 23% of pa- tients (n=8) in the Staples-group, but was entirely absent in the OWC-group (p<0.003). For every four patients treated with OWC, one complication of PWD of 7 days or more was prevented (NNT = 4). Conclusions: This study provides strong evidence that occlusive wound closure (OWC) significantly reduces degree and duration of wound discharge in patients undergoing tumor resection and endoprosthetic reconstruction of the proximal femur and prevents PWD of 7 days or more in comparison to conventional skin staples. 3.