{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,14]],"date-time":"2026-09-14T16:07:38Z","timestamp":1789402058055,"version":"build-2803163510"},"reference-count":33,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2024,2,6]],"date-time":"2024-02-06T00:00:00Z","timestamp":1707177600000},"content-version":"vor","delay-in-days":5,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2024,2,1]],"date-time":"2024-02-01T00:00:00Z","timestamp":1706745600000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Knee surg. sports traumatol. arthrosc."],"published-print":{"date-parts":[[2024,2]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Purpose<\/jats:title>\n                    <jats:p>This study aimed to formulate evidence\u2010based recommendations for optimising wound management in hip and knee arthroplasty by exploring alternative methods such as barbed sutures and skin adhesives.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>A Delphi panel, comprising seven orthopaedic surgeons, one musculoskeletal infectious disease specialist, and one health economics expert, was convened to evaluate the use of barbed sutures and skin adhesives for wound closure in hip and knee arthroplasty. Two systematic reviews informed the development of questionnaires, with panelists ranking their agreement on statements using a 5\u2010point Likert scale. Consensus was achieved if \u226575% agreement. Unresolved statements were revisited in a second round.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Consensus was reached on 11 statements, providing evidence\u2010based recommendations. The expert panel advocates for a multilayer watertight technique using barbed sutures to prevent surgical site infections (SSI), reduce complications, shorten surgical times, optimise resources and improve cosmetic appearance. For skin closure, the panel recommends topical adhesives to decrease wound dehiscence, enhance cosmetic appearance, promote patient compliance, prevent SSIs, and optimise resources.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>The Delphi consensus by Italian total joint arthroplasty experts underscores the pivotal role of barbed sutures and skin adhesives in optimising outcomes. While guiding clinical decision\u2010making, these recommendations are not prescriptive and should be adapted to local practices. The study encourages further research to enhance current evidence.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Level of Evidence<\/jats:title>\n                    <jats:p>Level III.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/ksa.12055","type":"journal-article","created":{"date-parts":[[2024,2,7]],"date-time":"2024-02-07T02:14:25Z","timestamp":1707272065000},"page":"303-310","source":"Crossref","is-referenced-by-count":3,"title":["Barbed sutures and skin adhesives improve wound closure in hip and knee arthroplasty"],"prefix":"10.1002","volume":"32","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-3686-3137","authenticated-orcid":false,"given":"Emilio","family":"Romanini","sequence":"first","affiliation":[{"name":"RomaPro Centre for Hip and Knee Arthroplasty, Polo Sanitario San Feliciano Rome Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6213-9089","authenticated-orcid":false,"given":"Gustavo A.","family":"Zanoli","sequence":"additional","affiliation":[{"name":"Casa di Cura Santa Maria Maddalena Occhiobello RO Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0422-690X","authenticated-orcid":false,"given":"Tiziana","family":"Ascione","sequence":"additional","affiliation":[{"name":"Service of Infectious Diseases, AORN A. Cardarelli Naples Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0392-4511","authenticated-orcid":false,"given":"Giovanni","family":"Balato","sequence":"additional","affiliation":[{"name":"Department of Public Health Federico II University of Naples  Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6073-8491","authenticated-orcid":false,"given":"Andrea","family":"Baldini","sequence":"additional","affiliation":[{"name":"IFCA Institute Florence Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1381-9069","authenticated-orcid":false,"given":"Emanuela","family":"Foglia","sequence":"additional","affiliation":[{"name":"School of Management Engineering and Healthcare Datascience LAB, Carlo Cattaneo\u2013 LIUC University and LIUC Business School Castellanza VA Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2969-4897","authenticated-orcid":false,"given":"Antonio V.","family":"Pellegrini","sequence":"additional","affiliation":[{"name":"UO CRIO, IRCCS Ospedale Galeazzi\u2010Sant'Ambrogio Milano Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2488-1546","authenticated-orcid":false,"given":"Francesco","family":"Verde","sequence":"additional","affiliation":[{"name":"IRCCS Ospedale San Raffaele Milano Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2941-1407","authenticated-orcid":false,"given":"Stefano","family":"Zaffagnini","sequence":"additional","affiliation":[{"name":"Universit\u00e0 di Bologna, Clinica Ortopedica e Traumatologica, Istituto Ortopedico Rizzoli Bologna Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2024,2,6]]},"reference":[{"key":"e_1_2_12_2_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00264-018-4165-7"},{"key":"e_1_2_12_3_1","doi-asserted-by":"publisher","DOI":"10.1089\/sur.2022.146"},{"key":"e_1_2_12_4_1","doi-asserted-by":"publisher","DOI":"10.1093\/bjs\/znac196"},{"key":"e_1_2_12_5_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.arth.2018.09.066"},{"key":"e_1_2_12_6_1","doi-asserted-by":"publisher","DOI":"10.1302\/0301-620X.95B11.33135"},{"key":"e_1_2_12_7_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00167-021-06742-1"},{"key":"e_1_2_12_8_1","doi-asserted-by":"publisher","DOI":"10.1086\/676022"},{"key":"e_1_2_12_9_1","volume-title":"Global guidelines for the prevention of surgical site infection","author":"Guidelines Review Committee, Infection Prevention and Control (IPC)","year":"2018"},{"key":"e_1_2_12_10_1","unstructured":"Healthcare Infection Control Practices Advisory Committee. 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