Abstract
In total hip arthroplasty (THA), the handling of surgical incisions is of tremendous importance for both effective wound healing and positive patient results. Even with the evolution of surgical methods, there remain major hurdles in managing these incisions to avoid complications and infections. This study aimed to address the critical evidence gaps in wound management in THA, encompassing aspects such as presurgical preparation, choices during the surgery, and postsurgical complications.
Employing a modified Delphi technique, this study assembled a group of 20 distinguished orthopaedic surgeons from Europe and North America. Spanning from April 1, 2023, to September 30, 2023, the study was structured in 3 phases: a preliminary online questionnaire, a remote conference session, and a final online questionnaire. The expert panel evaluated and achieved agreement on 18 distinct consensus statements regarding wound care in THA, guided by an extensive review of existing literature. Throughout these phases, with additional reviews by the panel, a secondary objective emerged: to pinpoint critical evidence gaps in the current knowledge of wound care techniques specific to THA.
The panel achieved consensus on 18 statements regarding wound management in THA. Key findings highlighted critical evidence gaps in several areas: the effectiveness of mesh-adhesive dressings in reducing wound complications; optimal closure techniques comparing skin adhesives, staples, and sutures; the cost-benefit analysis of barbed stitches; and the specific use cases for negative-pressure wound therapy. These results indicate a need for targeted research to validate and expand upon these preliminary findings, aiming to develop standardized, evidence-based guidelines for wound management in THA.
The review of these critical evidence gaps points to a need for specific research in wound management for THA. It is important to address these gaps to develop better, more efficient, and patient-friendly wound care methods. Future research should focus on these areas, particularly on studies that compare different treatments and help establish clear guidelines for using new technologies. Closing these gaps could lead to better patient outcomes, fewer complications, and a higher success rate in THA.