Identifying Critical Evidence Gaps in Wound Closure and Incision Management After Total Hip Arthroplasty: Delphi...

Area of Science:

• Orthopedic Surgery
• Wound Healing Research
• Arthroplasty Care

Background:

• Effective surgical incision management is crucial for optimal wound healing and patient outcomes in total hip arthroplasty (THA).
• Despite surgical advancements, challenges persist in preventing complications and infections associated with THA wounds.
• This study focused on identifying evidence gaps in THA wound care, encompassing presurgical, intraoperative, and postsurgical aspects.

Purpose of the Study:

• To identify evidence gaps in total hip arthroplasty (THA) wound care.
• To achieve consensus on best practices for THA wound management.
• To pinpoint areas requiring further research to improve patient outcomes.

Main Methods:

• A modified Delphi method was employed, involving 20 orthopedic surgeons from Europe and North America.
• A 3-phase consensus process included questionnaires, a remote conference, and an online survey.
• The panel reviewed literature and reached agreement on 18 consensus statements regarding THA wound care.

Main Results:

• Eighteen consensus statements were achieved regarding THA wound care.
• Key evidence gaps were identified concerning mesh-adhesive dressings, closure methods (adhesives, staples, sutures), barbed suture cost-effectiveness, and negative pressure wound therapy (NPWT) application.
• The findings underscore the necessity for further research to validate best practices and establish standardized protocols.

Conclusions:

• Addressing identified evidence gaps is vital for enhancing total hip arthroplasty (THA) wound care.
• Future research should compare closure techniques and novel technologies for patient-centered strategies.
• Bridging these knowledge gaps can potentially reduce complications, improve outcomes, and lessen the burden of wound-related issues in THA.