# Preheating 2-Octyl Cyanoacrylate Reduces Curing Time in Robotic Total Knee Arthroplasty: A Pilot Randomized Study

## TL;DR

Preheating a surgical adhesive slightly reduces drying time during robotic knee replacement surgery, but the time saved is not enough to significantly improve efficiency.

## Contribution

This is the first clinical study to investigate the effect of preheating 2-octyl cyanoacrylate adhesive in robotic-assisted total knee arthroplasty.

## Key findings

- Preheated adhesive reduced drying time by an average of 26.8 seconds compared to ambient temperature adhesive.
- No significant differences were found in preparation time or incision size between preheated and control groups.

## Abstract

Introduction

Tissue adhesives, such as 2-octyl cyanoacrylate, are widely used for tissue approximation and protection of surgical wounds during total knee arthroplasty (TKA). However, drying time for tissue adhesives can increase overall operating time and impede efficiency. Various methods may reduce the drying time of tissue adhesives. However, there is currently no clinical or in vivo data to support these findings. This study aims to investigate whether preheated 2-octyl cyanoacrylate (Dermabond™, Ethicon, Inc., Somerville, NJ, US) shortens drying time in robotic-assisted TKA.

Methods

This randomized pilot study included 40 patients undergoing TKA, and they were randomized into two groups: the intervention group received Dermabond™ preheated in a solution warmer device, while the control group received Dermabond™ at ambient temperature. Incision size, preparation, and drying times were recorded and compared. Comparison of drying time, preparation time, incision size, BMI, weight, height, age, surgery time, and gender between the preheated and control groups was conducted using the t-test, Levene’s test, and the chi-squared test.

Results

Data from 39 patients were analyzed, as one intervention failed due to premature Dermabond™ drying in the preheated group. The drying time was reduced by an average of 26.8 seconds in the preheated group compared to the control group (p < 0.05). No significant differences were observed in preparation time or incision size between the groups.

Conclusion

Preheating Dermabond™ reduces drying time; however, the reduction does not provide substantial time savings to alter the current TKA workflow. Improvements in intraoperative efficiency may be better achieved by optimizing other aspects of the procedure.