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Poster: 91So Are Sutures Actually Better Than Staples in Prevention of SuperficialWound Infections After Primary Total Hip Replacement?*Ahsan Sheeraz - Royal National Orthopaedic Hospital, Stanmore - London, UKNatasha Picardo - Royal National Orthopaedic Hospital - Stanmore, United KingdomDaniel Shaerf - RNOH, Stanmore - London, UKSarah Muirhead-Allwood - Royal National Orthopaedic Hospital Trust - Stanmore, UKJohn Skinner - Royal National Orthopaedic Hospital Trust - Stanmore, UKIntroduction:*Email: ahsanshiraz@hotmail.comA meta-analysis (BMJ 2010;340:c1199) was published recently which concluded that the riskof superficial wound infections with staples was four times greater than with sutures after hipsurgery. This was a significant finding and before deciding to change our practice we decided todo a baseline audit. The aim of this audit was to assess our preferred choice of skin closurefollowing a Total Hip Replacement (THR) and the resulting superficial infection rates.Methods:80 patients undergoing a primary THR before the publication of the meta-analysis wereidentified. All primary hips of all ages and risk factors were included in the audit. Data wasthen obtained from paper and electronic records.Results:Of the 80 patients that had a THR, 16 had their wounds closed with sutures and 64 with metalclips/staples. Nearly half of the procedures were performed by trainees as we are a teachinghospital. In the suture group none had any wound complications, however in the staples group 6out of the 64 developed wound complications. 4 of these patient’s required oral antibiotics foroozy/infected wounds and all 4 grew organisms on wound swabs. 1 patient required Intravenousantibiotics for 24 hours for wound dehiscence; the wound swab however did not growany organisms. 1 patient required a wound washout and intra-venous antibiotics for 6 weeks; hehad a heavy growth of mixed organisms. The infections in all patients were successfullyeradicated and all wounds had healed at last follow up. Thus the wound infection rate in thestaples group was 7.8% and in the suture group 0%.Discussion:The objective of good wound closure is rapid skin healing and an acceptable cosmetic resultwhile minimising wound complications like dehiscence or infection. The meta-analysis lookedat 683 wounds and concluded that superficial wound infection rates were 3 times higher withstaples in Trauma & Orthopaedic surgery as compared to sutures and 4 times higher if onlypost-operative hip surgical wounds were considered. The difference in infection rates wasstatistically significant, but there was no difference in the incidence of inflammation, discharge,file:///E|/ISTA2010-Abstracts.htm[12/7/2011 3:15:47 PM]