[Translated article] Wound closure after knee and hip replacement (TKA and THA): Survey results on the clinical practice in Spain.

Autor: Sanz Ruiz P; Servicio de Cirugía Ortopédica y Traumatología, Hospital General Universitario Gregorio Marañón, Madrid, Spain. Electronic address: pablo.sanzruiz@gmail.com., Caeiro Rey JR; Servicio de Cirugía Ortopédica y Traumatología, Complejo Hospitalario Universitario de Santiago de Compostela, Santiago de Compostela, Spain., Martínez Pastor JC; Servicio de Cirugía Ortopédica y Traumatología, Hospital Clínic de Barcelona, Barcelona, Spain., Martín Alguacil JL; Servicio de Cirugía Ortopédica y Traumatología, Hospital Vithas de Granada, Granada, Spain., Murcia Asensio A; Servicio de Cirugía Ortopédica y Traumatología, Hospital General Universitario Reina Sofía, Murcia, Spain., Moreta Suárez J; Servicio de Cirugía Ortopédica y Traumatología, Hospital Universitario Galdakao-Usansolo, Bizkaia, Spain.
Jazyk: English; Spanish; Castilian
Zdroj: Revista espanola de cirugia ortopedica y traumatologia [Rev Esp Cir Ortop Traumatol] 2024 Mar-Apr; Vol. 68 (2), pp. T97-T107. Date of Electronic Publication: 2023 Nov 20.
DOI: 10.1016/j.recot.2023.11.005
Abstrakt: Background and Objective: In orthopaedic surgery, it is clear that an optimal standardised closure technique has not yet been developed. Locally, there are no objective data describing the standard surgical practice in wound closure. The aim of this study is to analyse the clinical practice of surgical wound closure in orthopaedic surgery by means of a survey of a representative local sample and thus obtain information on the context of closure in Spain.
Material and Method: An ad hoc group of specialists in orthopaedic surgery and traumatology was formed. The group of experts, after analyzing the literature, developed a questionnaire of 32 closed multiple-choice questions divided into the following blocks: hemostasis, surgical wound closure (deep, superficial, and cutaneous), and dressings.
Results: A total of 471 surgeons responded to the survey completely and with sufficient information to perform the descriptive analysis. 79% believe that ATX can influence the decrease in surgical site infection rate. 96% believe that the type of deep closure at the level of the arthrotomy could influence outcomes and complications after hip and/or knee replacements. 85% believe that the type of shallow closure at the subcutaneous level may influence outcomes and complications after hip and/or knee replacement. 64% of surgeons use single-use incisional negative pressure therapy for the treatment of surgical wound complications (seroma, prolonged drainage, dehiscence).
Conclusions: There is a high level of variability in wound closure in our setting and a low level of training on the subject. The authors recommend that the different scientific societies invest resources to improve training in this field and reduce the percentage of surgeons who are considered inadequately trained, as well as adapting closure techniques to those considered gold standard according to the evidence.
(Copyright © 2023 SECOT. Publicado por Elsevier España, S.L.U. All rights reserved.)
Databáze: MEDLINE
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