Seventy patients with metastatic bone disease of the proximal femur undergoing tumor resection and endoprosthetic reconstruction were randomized to receive occlusive wound closure with Dermabond Prineo-22 (n=35) or conventional skin staples (n=35). The primary outcome was time to dry wound status. Secondary outcomes included degree and duration of wound discharge, duration of antibiotic treatment, and hospital stay. Outcomes were assessed daily until discharge. Overall, the study revealed that occlusive wound closure significantly reduced the degree and duration of wound discharge, with no cases of prolonged wound discharge (≥7 days) in the occlusive group compared to 23% in the staples group. These findings suggest occlusive closure can effectively prevent prolonged wound discharge in high-risk orthopedic oncology patients.