Identifying Critical Evidence Gaps in Wound Closure and Incision Management After Total Hip Arthroplasty: Delphi Panel Insights

Authors

Margaret Ainslie-Garcia
Lucas Anderson
Benjamin Bloch
Tim N Board
Antonia Chen
Samantha Craigie
Walter Danker
Najmuddin Gunja
James Harty
Victor Hernandez
Kate Lebedeva
Mitchell Ng
Daniel Hameed
Michael Mont
Ryan Nunley
Javad Parvizi, Thomas Jefferson UniversityFollow
Sean Sequeira
Carsten Perka
Nicolas Piuzzi
Ola Rolfson
Joshua Rychlik
Emilio Romanini
Pablo Sanz-Ruiz
Rafael Sierra
Linda Suleiman
Eleftherios Tsiridis
Pascal-André Vendittoli
Helge Wangen
Luigi Zagra

Document Type

Article

Publication Date

8-1-2025

Comments

This article is the author's final published version in Arthroplasty Today, Volume 34, 2025, 101693.

The published version is available at https://doi.org/10.1016/j.artd.2025.101693.

Copyright © 2025 The Authors

Abstract

BACKGROUND: 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.

METHODS: 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.

RESULTS: 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.

CONCLUSIONS: 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.

Recommended Citation

Ainslie-Garcia, Margaret; Anderson, Lucas; Bloch, Benjamin; Board, Tim N; Chen, Antonia; Craigie, Samantha; Danker, Walter; Gunja, Najmuddin; Harty, James; Hernandez, Victor; Lebedeva, Kate; Ng, Mitchell; Hameed, Daniel; Mont, Michael; Nunley, Ryan; Parvizi, Javad; Sequeira, Sean; Perka, Carsten; Piuzzi, Nicolas; Rolfson, Ola; Rychlik, Joshua; Romanini, Emilio; Sanz-Ruiz, Pablo; Sierra, Rafael; Suleiman, Linda; Tsiridis, Eleftherios; Vendittoli, Pascal-André; Wangen, Helge; and Zagra, Luigi, "Identifying Critical Evidence Gaps in Wound Closure and Incision Management After Total Hip Arthroplasty: Delphi Panel Insights" (2025). Department of Orthopaedic Surgery Faculty Papers. Paper 244.
https://jdc.jefferson.edu/orthofp/244

Creative Commons License

This work is licensed under a Creative Commons Attribution-Noncommercial-No Derivative Works 4.0 License.

PubMed ID

40678786

Language

English