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Closure of hip wound, clips or subcuticular sutures: does it make a difference?

Fermeture de l’incision en chirurgie de la hanche: agrafes ou suture intradermique?

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Abstract

The purpose of this study was to investigate wound healing and complications following surgery for fracture neck of femur. Seventy-one patients were prospectively divided into two groups, according to the method of skin closure: group A had clips; group B had subcuticular vicryl® sutures. There were 41 patients in group A, and 30 patients in group B. There were 13 males and 58 females with an average age of 84.3 years (range 67–100 years). Thirty-seven patients underwent fixation with a dynamic hip screw, while 34 had undergone either a hemi or total hip arthroplasty. The wounds were inspected at days 2, 5, 7, 10 and 14 days, for discharge, redness and infection. There was a statistically significantly greater amount of wound discharge (P<0.002) and redness (P<0.009) in group A (clips) as compared to group B (vicryl). There were three cases of infection; all in patients where clips had been used for skin closure. We concluded that subcuticular vicryl sutures were significantly better than clips in terms of wound healing as well as cost. Except for some decrease in operative time there does not seem to be any advantage in the use of clips for wound closure.

Résumé

Le but de ce travail est d’étudier les problèmes de cicatrisation et les complications de la chirurgie pour fracture du col fémoral. 71 patients ont été prospectivement divisés en 2 groupes, selon le mode de fermeture cutanée : le groupe A (41 patients) a reçu des agrafes, le groupe B (30 patients) une suture résorbable (Vicryl®). Il y avait 13 hommes et 58 femmes d’âge moyen 84,3 ans (67–100 ans). 37 patients ont bénéfice d’une ostéosynthèse par vis plaque à compression (DHS) tandis que 34 ont reçu une arthroplastie. Les cicatrices ont été suivies à J 2, J5, J7, J10 et J14 à la recherche d’écoulement, rougeur ou infection. Il existe de façon significative (P<0,002) plus d’écoulements et de rougeurs dans le groupe A que dans le groupe B. Trois infections ont été relevées, toutes sont survenues dans le groupe où les agrafes ont été utilisées pour la fermeture. Nous concluons que les sutures résorbables sous-cutanées sont préférables aux agrafes en terme de cicatrisation et de coût. Mise à part la réduction du temps opératoire, il n’y a aucun avantage à utiliser des agrafes pour la fermeture cutanée.

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Authors and Affiliations

  1. Trauma & Orthopaedics, Mayday University Hospital, Crodyon, London, UK

    Bijayendra Singh & M. A. S. Mowbray

  2. Orthogeriatric Unit, Mayday University Hospital, London Road, Thornton Heath, London, UK

    G. Nunn & S. Mearns

  3. 2 Trapham Road, Maidstone, ME16 0EL, England

    Bijayendra Singh

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  1. Bijayendra Singh
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  2. M. A. S. Mowbray
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  3. G. Nunn
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  4. S. Mearns
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Correspondence to Bijayendra Singh.

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Singh, B., Mowbray, M.A.S., Nunn, G. et al. Closure of hip wound, clips or subcuticular sutures: does it make a difference?. Eur J Orthop Surg Traumatol 16, 124–129 (2006). https://doi.org/10.1007/s00590-005-0043-2

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  • DOI: https://doi.org/10.1007/s00590-005-0043-2

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