Ainslie-Garcia Margaret H, Anderson Lucas A, Bloch Benjamin V, Board Tim N, Chen Antonia F, Craigie Samantha, Danker Walter, Gunja Najmuddin, Harty James, Hernandez Victor H, Lebedeva Kate, Ng Mitchell K, Hameed Daniel, Mont Michael A, Nunley Ryan M, Parvizi Javad, Sequeira Sean B, Perka Carsten, Piuzzi Nicolas S, Rolfson Ola, Rychlik Joshua, Romanini Emilio, Sanz-Ruiz Pablo, Sierra Rafael J, Suleiman Linda, Tsiridis Eleftherios, Vendittoli Pascal-André, Wangen Helge, Zagra Luigi
Department of Value and Evidence, EVERSANA, Burlington, Ontario, Canada.
Department of Orthopaedic Surgery, University of Utah Orthopaedic Center, Salt Lake City, UT, USA.
Arthroplast Today. 2025 Jul 3;34:101693. doi: 10.1016/j.artd.2025.101693. eCollection 2025 Aug.
In total hip arthroplasty (THA), proper management of surgical incisions is essential for optimal wound healing and patient outcomes. Despite advances in surgical techniques, significant challenges remain in preventing complications and infections. This study aimed to identify evidence gaps in THA wound care, including presurgical preparation, intraoperative practices, and postsurgical complications.
Using a modified Delphi method, 20 expert orthopedic surgeons from Europe and North America participated in a 3-phase consensus process from April 1 to September 30, 2023. This included a preliminary questionnaire, a remote conference, and a final online survey. The panel reviewed literature and achieved agreement on 18 consensus statements regarding wound care in THA. A secondary aim was to identify critical gaps in current wound care knowledge.
Consensus was reached on 18 statements. Key gaps were identified in the effectiveness of mesh-adhesive dressings, optimal closure methods (skin adhesives, staples, sutures), cost benefit of barbed sutures, and appropriate use of negative pressure wound therapy. These findings highlight the need for further research to validate best practices and guide standardized evidence-based protocols.
Addressing these evidence gaps is essential to improve THA wound care methods. Future studies should compare closure techniques and new technologies to develop more efficient patient-centered strategies. Bridging these gaps may reduce complications, enhance outcomes, and lower the burden of wound-related issues in THA.
在全髋关节置换术（THA）中，手术切口的妥善管理对于实现最佳伤口愈合和患者预后至关重要。尽管手术技术有所进步，但在预防并发症和感染方面仍存在重大挑战。本研究旨在确定THA伤口护理方面的证据空白，包括术前准备、术中操作和术后并发症。
采用改良的德尔菲法，来自欧洲和北美的20位骨科专家参与了2023年4月1日至9月30日的三阶段共识达成过程。这包括一份初步问卷、一次远程会议和一次最终在线调查。该小组查阅了文献，并就18条关于THA伤口护理的共识声明达成了一致。第二个目标是确定当前伤口护理知识中的关键空白。
就18条声明达成了共识。在网状粘性敷料的有效性、最佳闭合方法（皮肤粘合剂、吻合钉、缝线）倒刺缝线的成本效益以及负压伤口治疗的适当使用方面发现了关键空白。这些发现凸显了进一步研究以验证最佳实践并指导标准化循证方案的必要性。
填补这些证据空白对于改善THA伤口护理方法至关重要。未来的研究应比较闭合技术和新技术，以制定更有效的以患者为中心的策略。弥合这些差距可能会减少并发症、改善预后并减轻THA中与伤口相关问题的负担。
