Related Experiment Video
Updated: Dec 23, 2025
The Generation of Closed Femoral Fractures in Mice: A Model to Study Bone Healing
Published on: August 16, 2018
Effect of Wound Closure Technique in Proximal Femoral Fractures: A Prospective Cohort Study
Inas Azzah Badres1, Kary Suen1, Phong Tran1,2
1Department of Orthopaedic Surgery, Western Health, Foootscray, Victoria, Australia; and.
Objectives:
To compare the effect of different wound closure techniques on wound drainage, postoperative length of stay, and complications in patients with proximal femoral fractures, including femoral neck fractures (31A fractures) and peritrochanteric fractures (31B fractures).
Design:
Prospective cohort study.
Setting:
Footscray Hospital, Western Health, Victoria, Australia; an acute teaching hospital.
Patients And Participants:
All inpatients receiving surgery for proximal femoral fractures at our facility between May 2016 and August 2017. A total of 486 consecutive patients who presented during the study period were included in the study.
Intervention:
Three cohorts of consecutive patients were assigned to use either skin staples, monofilament absorbable subcuticular sutures (Monocryl), or, sutures with the addition of 2-octylcyanoacrylate (OCA) (Monocryl and Dermabond), respectively, for skin closure according to when the patients entered the study.
Main Outcome Measurements:
The primary outcome of interest was prolonged wound drainage measured using a standardized technique after postoperative day 3. Secondary outcomes included inpatient length of stay and overall complications.
Results:
We found a statistically significant increase in prolonged wound drainage in the staples cohort compared with the subcuticular sutures cohort and the sutures and OCA cohort (21.1% vs. 8.5% vs. 4.4%, P < 0.001). Inpatient length of stay was also significantly increased in the staples cohort (5.83 days vs. 4.78 days vs. 5.5 days, P = 0.005). There were no statistically significant differences between the 3 cohorts when comparing incidence of any medical complications, withholding of thromboprophylactic agents, or usage of topical negative pressure dressings.
Conclusions:
In patients with proximal femoral fractures, closure with staples has the highest rate of prolonged wound drainage and length of stay. Subcuticular sutures in combination with OCA result in the lowest incidence of prolonged wound drainage.
Level Of Evidence:
Therapeutic Level II. See Instructions for Authors for a complete description of levels of evidence.
More Related Videos
20:33A Case Series of Successful Abdominal Closure Utilizing a Novel Technique Combining a Mechanical Closure System with a Biologic Xenograft that Accelerates Wound Healing
Published on: July 4, 2019
04:41Treatment with Locking Intramedullary Nailing for Intertrochanteric Fracture of the Femur Utilizing a New Awl with a Distal Positioner
Published on: June 6, 2025
