TY - JOUR
T1 - International Delphi Study on Wound Closure and Incision Management in Joint Arthroplasty Part 2
T2 - Total Hip Arthroplasty
AU - Ainslie-Garcia, Margaret
AU - Anderson, Lucas A.
AU - Bloch, Benjamin V.
AU - Board, Tim N.
AU - Chen, Antonia F.
AU - Craigie, Samantha
AU - Danker, Walter
AU - Gunja, Najmuddin
AU - Harty, James
AU - Hernandez, Victor H.
AU - Lebedeva, Kate
AU - Hameed, Daniel
AU - Mont, Michael A.
AU - Nunley, Ryan M.
AU - Parvizi, Javad
AU - Perka, Carsten
AU - Piuzzi, Nicolas S.
AU - Rolfson, Ola
AU - Rychlik, Joshua
AU - Romanini, Emilio
AU - Sanz-Ruiz, Pablo
AU - Sierra, Rafael J.
AU - Suleiman, Linda
AU - Tsiridis, Eleftherios
AU - Vendittoli, Pascal André
AU - Wangen, Helge
AU - Zagra, Luigi
N1 - Publisher Copyright:
© 2024 The Authors
PY - 2024/6
Y1 - 2024/6
N2 - Background: This modified Delphi study aimed to develop a consensus on optimal wound closure and incision management strategies for total hip arthroplasty (THA). Given the critical nature of wound care and incision management in influencing patient outcomes, this study sought to synthesize evidence-based best practices for wound care in THA procedures. Methods: An international panel of 20 orthopedic surgeons from Europe, Canada, and the United States evaluated a targeted literature review of 18 statements (14 specific to THA and 4 related to both THA and total knee arthroplasty). There were 3 rounds of anonymous voting per topic using a modified 5-point Likert scale with a predetermined consensus threshold of ≥ 75% agreement necessary for a statement to be accepted. Results: After 3 rounds of voting, consensus was achieved for all 18 statements. Notable recommendations for THA wound management included (1) the use of barbed sutures over non-barbed sutures (shorter closing times and overall cost savings); (2) the use of subcuticular sutures over skin staples (lower risk of superficial infections and higher patient preferences, but longer closing times); (3) the use of mesh-adhesives over silver-impregnated dressings (lower rate of wound complications); (4) for at-risk patients, the use of negative pressure wound therapy over other dressings (lower wound complications and reoperations, as well as fewer dressing changes); and (5) the use of triclosan-coated sutures (lower risk of surgical site infection) over standard sutures. Conclusions: Through a structured modified Delphi approach, a panel of 20 orthopedic surgeons reached consensus on all 18 statements pertaining to wound closure and incision management in THA. This study provides a foundational framework for establishing evidence-based best practices, aiming to reduce variability in patient outcomes and to enhance the overall quality of care in THA procedures.
AB - Background: This modified Delphi study aimed to develop a consensus on optimal wound closure and incision management strategies for total hip arthroplasty (THA). Given the critical nature of wound care and incision management in influencing patient outcomes, this study sought to synthesize evidence-based best practices for wound care in THA procedures. Methods: An international panel of 20 orthopedic surgeons from Europe, Canada, and the United States evaluated a targeted literature review of 18 statements (14 specific to THA and 4 related to both THA and total knee arthroplasty). There were 3 rounds of anonymous voting per topic using a modified 5-point Likert scale with a predetermined consensus threshold of ≥ 75% agreement necessary for a statement to be accepted. Results: After 3 rounds of voting, consensus was achieved for all 18 statements. Notable recommendations for THA wound management included (1) the use of barbed sutures over non-barbed sutures (shorter closing times and overall cost savings); (2) the use of subcuticular sutures over skin staples (lower risk of superficial infections and higher patient preferences, but longer closing times); (3) the use of mesh-adhesives over silver-impregnated dressings (lower rate of wound complications); (4) for at-risk patients, the use of negative pressure wound therapy over other dressings (lower wound complications and reoperations, as well as fewer dressing changes); and (5) the use of triclosan-coated sutures (lower risk of surgical site infection) over standard sutures. Conclusions: Through a structured modified Delphi approach, a panel of 20 orthopedic surgeons reached consensus on all 18 statements pertaining to wound closure and incision management in THA. This study provides a foundational framework for establishing evidence-based best practices, aiming to reduce variability in patient outcomes and to enhance the overall quality of care in THA procedures.
KW - consensus development
KW - incision management
KW - modified Delphi study
KW - orthopaedic surgery practices
KW - total hip arthroplasty (THA)
KW - wound closure
UR - http://www.scopus.com/inward/record.url?scp=85186609989&partnerID=8YFLogxK
U2 - 10.1016/j.arth.2024.01.047
DO - 10.1016/j.arth.2024.01.047
M3 - Article
C2 - 38325531
AN - SCOPUS:85186609989
SN - 0883-5403
VL - 39
SP - 1524
EP - 1529
JO - Journal of Arthroplasty
JF - Journal of Arthroplasty
IS - 6
ER -