Reduced Wound Complications With Absorbable Deep Dermal Staples in Direct Anterior Total Hip Arthroplasty

Area of Science:

• Orthopedic Surgery
• Wound Healing
• Biomaterials

Background:

• Direct anterior approach (DAA) for total hip arthroplasty (THA) offers muscle-sparing benefits.
• Wound complications are a known limitation of the DAA technique.
• Evaluating novel closure methods is crucial for improving DAA THA outcomes.

Purpose of the Study:

• To compare the efficacy of absorbable staple augmentation versus barbed sutures for wound closure in DAA THA.
• To investigate the impact of body mass index (BMI) on wound complication rates.
• To determine if absorbable staples reduce wound complications, particularly in obese patients.

Main Methods:

• Retrospective review of 703 primary DAA THA cases.
• Comparison of two wound closure groups: absorbable intradermal staples (n=357) and barbed sutures (n=346).
• Analysis of demographics, wound complications, and reoperation rates for wound issues.

Main Results:

• The absorbable staple group showed a significantly lower wound complication rate (2.8% vs. 8.1%, P < 0.002).
• No significant difference in return to the operating room for wound complications between groups.
• Higher BMI was associated with wound complications in both groups (P < 0.001).

Conclusions:

• Absorbable staple augmentation is associated with fewer wound complications than barbed sutures in DAA THA.
• Obesity remains a risk factor for wound complications, even with improved closure techniques.
• Absorbable staples may offer a superior, practical wound closure method for DAA THA, warranting further investigation.