Staples significantly increase risk of postoperative infection study

nospam@example.com (Patricia Walter) — Fri, 02 Apr 2010 08:45:39 -0700

Staples significantly increase risk of postoperative infection study

March 2010 Original Link http://www.orthosupersite.com/view.aspx?rid=62584

The use of staples to close wounds following orthopedic surgery - especially hip surgery - is associated with a significantly greater risk of wound infection than traditional suturing, according to orthopedic researchers from Norwich, England.

Six clinical trials

Toby O. Smith, MSc, BSc (Hons), MCSP, and colleagues analyzed the results of six trials that compared staples and sutures used for wound closure following orthopedic procedures in adult patients. The six clinical trials involved 683 wounds. Of these cases, 322 patients underwent suture closure and 351 patients had staple closure, according to a British Medical Journal press release.

The authors found that wounds closed with staples were more than three times as likely to develop a superficial wound infection compared to wounds closed with sutures. In a subgroup analysis of patients undergoing hip surgery, the risk of developing a wound infection was found to be four times greater after staple closure than suture closure, according to the release.

Staples not recommended

The researchers found no significant difference between staples and sutures in the development of inflammation, discharge, dehiscence, necrosis and allergic reaction.

The authors called for high quality, well-designed trials to confirm their findings.

Although the quality of evidence from the six trials was generally poor, the authors concluded, "With the current evidence, however, patients and doctors should think more carefully about the use of staples for wound closure after hip and knee surgery."

•Reference:
Smith TO, Sexton D, Mann C, et al. Sutures versus staples for skin closure in orthopaedic surgery: meta-analysis. BMJ. [Published online ahead of print March 16, 2010]

A Modified Posterior Approach Preserves Femoral Head Oxgenation During Hip 2010

nospam@example.com (Patricia Walter) — Sun, 28 Mar 2010 09:53:20 -0700

A Modified Posterior Approach Preserves Femoral Head Oxgenation During Hip Resurfacing 2010

Steffen RT, De Smet KA, Murray DW, Gill HS 2010 Mar 22

Original Link http://www.ncbi.nlm.nih.gov/pubmed/20334994?dopt=AbstractPlus

Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, University of Oxford, Nuffield Orthopaedic Centre, Oxford, UK.

In 11 patients, the oxygenation was measured in the superolateral quadrant of the femoral head during resurfacing with a modified posterior approach, designed to preserve the blood supply, using a gas-sensitive electrode. These were compared with measures from 10 patients in whom the standard posterior approach was used. The modified approach patients maintained a significantly (P < .005) higher amount of relative oxygenation after the approach, 78% (standard deviation [SD], 45%) vs 38% (SD, 26%), and acetabular component implantation, 74% (SD, 56%) vs 20% (SD, 28%). The modified posterior approach, unlike the standard extended approach, does not significantly compromise the blood supply to the head; and we recommend this approach be considered for hip resurfacing.

Hip Resurfacing News - Approaches to Surgery

Staples significantly increase risk of postoperative infection study

A Modified Posterior Approach Preserves Femoral Head Oxgenation During Hip 2010