Wound complication rates after anterior total hip arthroplasty: A case series comparison of interrupted vs. continuous sutures for skin closure

J Orthop. 2024 Nov 1:63:130-134. doi: 10.1016/j.jor.2024.10.048. eCollection 2025 May.

Abstract

Background: The anterior approach for total hip arthroplasty (THA) carries a higher risk of wound complications, which can significantly affect patient outcomes and increase healthcare costs. There is limited research comparing infection rates based on closure techniques in patients who undergo THA. Therefore, this study aims to compare wound complications based on interrupted or continuous sutures for skin closure after anterior approach THA.

Methods: This single-surgeon retrospective study extracted data from 388 patients who had undergone a primary THA using the anterior approach. Patient demographics, comorbidities, perioperative factors, and infection-related complications were recorded. All variables associated with a given infection complication were controlled for in a binary logistic regression model.

Results: After controlling for confounding variables, wound closure type was not associated with any infectious complications. BMI was a strongly associated factor in PJI (p = 0.028; 95 % CI = 1.02-1.34), prolonged drainage (p < 0.001; 95 % CI = 1.08-1.28), readmission (p = 0.023; 95 % CI = 1.01-1.20), and I&D and revision surgery (p = 0.021; 95 % CI = 1.02-1.31).

Conclusion: Body mass index was the sole factor associated with a higher risk of wound complications postoperatively. These findings suggest a non-inferiority between continuous and interrupted suture closure techniques regarding wound-related infectious complications in anterior total hip arthroplasty.

Keywords: Arthroplasty; Hip replacement; Postoperative complications; Surgical sutures; Wound closure.