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Influence of skin incision position on physiological and biochemical changes in tissue after primary total knee replacement – A prospective randomised controlled trial

Overview of attention for article published in BMC Surgery, April 2015
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  • Above-average Attention Score compared to outputs of the same age (54th percentile)
  • Good Attention Score compared to outputs of the same age and source (78th percentile)

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Title
Influence of skin incision position on physiological and biochemical changes in tissue after primary total knee replacement – A prospective randomised controlled trial
Published in
BMC Surgery, April 2015
DOI 10.1186/s12893-015-0021-5
Pubmed ID
Authors

David Q Donaldson, Matthew Torkington, Iain C Anthony, Eugene F Wheelwright, Mark JG Blyth, Bryn G Jones

Abstract

Influence of skin incision position on physiological and biochemical changes in tissue after primary total knee replacement. A prospective randomised controlled trial. The blood supply to the skin covering the anterior knee has been shown to arise predominantly from blood vessels on the medial side of the knee. Skin incisions for primary Total Knee Replacement (TKR) positioned medially therefore risk creating a large lateral skin flap that may be poorly perfused. Poorly perfused skin is likely to result in hypoxia at the wound edges and consequently may lead to delayed wound healing and complications. We have carried out a randomised controlled trial (n = 20) to compare blood flow on both the medial and lateral sides of two commonly used skin incisions in TKR (midline and paramedian). We have also assessed interstitial biochemistry (glucose, pyruvate and lactate levels) in the presumed at risk lateral skin flap of both incision types. In both incision types tissue hyper-perfusion occurs post-operatively and is maintained for at least 3 days. We found no significant difference between blood flow between the two incision types on the medial side of the incision at either day 1 (p = 0.885) or day 3 post-op (p = 0.269), or, on the lateral side of the incision (p = 0.885 at day 1, p = 0.532 at day 3). Glucose levels are maintained post-operatively in the at risk lateral flap with only minimal changes. Lactate levels rise post-operatively and remain elevated for at least 24 hours. However, the levels did not reach levels suggestive of critical ischaemia in either incision group and no significant difference was observed between incision types. We conclude that the use of a paramedian incision results in only minimal biochemical changes, which are unlikely to alter wound healing. ISRCTN06592799 .

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Mendeley readers

Mendeley readers

The data shown below were compiled from readership statistics for 53 Mendeley readers of this research output. Click here to see the associated Mendeley record.

Geographical breakdown

Country Count As %
Unknown 53 100%

Demographic breakdown

Readers by professional status Count As %
Student > Master 7 13%
Researcher 6 11%
Student > Postgraduate 6 11%
Student > Bachelor 5 9%
Student > Doctoral Student 4 8%
Other 10 19%
Unknown 15 28%
Readers by discipline Count As %
Medicine and Dentistry 25 47%
Nursing and Health Professions 5 9%
Neuroscience 2 4%
Chemistry 1 2%
Unknown 20 38%
Attention Score in Context

Attention Score in Context

This research output has an Altmetric Attention Score of 3. This is our high-level measure of the quality and quantity of online attention that it has received. This Attention Score, as well as the ranking and number of research outputs shown below, was calculated when the research output was last mentioned on 31 December 2021.
All research outputs
#13,072,573
of 23,577,761 outputs
Outputs from BMC Surgery
#196
of 1,355 outputs
Outputs of similar age
#106,632
of 238,983 outputs
Outputs of similar age from BMC Surgery
#7
of 33 outputs
Altmetric has tracked 23,577,761 research outputs across all sources so far. This one is in the 44th percentile – i.e., 44% of other outputs scored the same or lower than it.
So far Altmetric has tracked 1,355 research outputs from this source. They receive a mean Attention Score of 1.9. This one has done well, scoring higher than 85% of its peers.
Older research outputs will score higher simply because they've had more time to accumulate mentions. To account for age we can compare this Altmetric Attention Score to the 238,983 tracked outputs that were published within six weeks on either side of this one in any source. This one has gotten more attention than average, scoring higher than 54% of its contemporaries.
We're also able to compare this research output to 33 others from the same source and published within six weeks on either side of this one. This one has done well, scoring higher than 78% of its contemporaries.