Wound complications after total hip arthroplasty: a prospective, randomised controlled trial comparing staples with sutures.
OrthoEvidence Journal (OE Journal) - ACE Report
OE Journal. 2025;13(20):3 Hip Int . 2025 Jul;35(4):326-331.What this means for my practice?
For primary THA skin closure, sutures substantially reduce early wound complications—particularly prolonged drainage—and likely lower SSIs compared with staples (trend). Clinically, choosing sutures may decrease early wound issues and related downstream interventions. Limitations include early trial termination (underpowering for SSI), inability to blind patients/clinicians, and heterogeneity in surgical approaches.
Study Summary
Five hundred thirty-five patients undergoing elective primary Total Hip Arthroplasty (THA) were randomized to cutaneous closure with staples (n=268) or sutures (n=267). The primary outcome was SSI (<6 weeks). Secondary outcomes included prosthetic joint infection (PJI, <1 year), other wound complications (prolonged discharge, dehiscence, necrosis; <6 weeks), and length of stay. Outcomes were assessed during admission, at discharge, then at 2 weeks (removal), 6 weeks, 3 months, and 1 year. Overall, the results of the study revealed a higher—nearly significant—SSI rate with staples and a clearly higher rate of early wound complications, driven by prolonged discharge; PJI did not differ. These findings suggest sutures should be preferred for skin closure after THA.
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