Prospective comparative clinical study on two skin closure techniques in primary total hip arthroplasty surgery

RUI Min; ZHENG Xin; SUN Shao-song; ZHANG Xing-chen; WANG Hai-bo; SHANG Jie; ZHAO Feng-chao; GUO Kai-jin

doi:10.3969/j.issn.2095-252X.2016.12.003

Abstract：Objective To compare the clinical outcomes of different skin closure techniques for primary total hip arthroplasty ( THA ). Methods A total of 76 patients, who had undergone primary unilateral THA through posterolateral approach from August 2014 to May 2015, were included in this comparative study. According to different skin closure techniques, the patients were randomized into staples group ( interrupted suture with staples ) in 41 cases and sutures group ( running 4-0 absorbable subcuticular suture ) in 35 cases. Same operative and perioperative care was provided to all patients. The infection rate, closure time, time to a dry wound, postoperative hospital stay and cosmetic results evaluated with HWES score and patient satisfaction with VAS score at postoperative 3 months follow-up were recorded and compared. Results Statistically significant differences ( P < 0.001 ) were observed in cutaneous closure time between the staples group [ required ( 24.2 ± 4.1 ) s ] and the sutures group [ required an average ( 360.5 ± 23.1 ) s ]. No infections developed in the sutures group, and 2 postoperative superficial infections ( 4.9% ) were observed in the staples group, with no significant differences between the groups ( P > 0.05 ). There were statistically significant differences in days to a dry wound [ ( 5.4 ± 1.5 ) days vs. ( 4.1 ± 1.2 ) days, P < 0.001 ] and postoperative hospital stay [ ( 11.5 ± 1.3 ) days vs. ( 6.4 ± 1.8 ) days, P < 0.001 ]. There were no significant differences in the Hollander wound evaluation score and patient satisfaction between the 2 groups. Conclusions There are no significant differences either in infection rate or in cosmetic assessment and patient satisfaction when metallic staples versus running absorbable subcuticular suture in primary THA surgery. Despite of less closure time with the use of staples in skin closure, the use of subcuticular suture has faster wound healing and a shorter postoperative hospital stay.