Abstract
Our audit examined the rates of complication in the surgical wounds of patients having surgery for fractured neck of femur, comparing the use of skin clips and an absorbable subcuticular suture.
The initial part of the audit compared the commonly used methods of skin closure at our institution, as outlined above. One hundred consecutive patients with fractured necks of femur (NOF) were studied. The closure of the wounds was randomly allocated between skin clips and subcuticular suture. The wounds were monitored for signs of complications, including infection, for the duration of hospital stay. It was found that the use of skin clips carried with it a significantly higher rate of complication (11.1% ) when compared with use of subcuticular absorbable suture (0% ). At this stage, we concluded that the latter method be adopted as departmental policy.
A further study was performed one year later to reevaluate the efficacy of the new practice. A further fifty consecutive patients with NOF were studied using the same parameters as before. Our results demonstrated that the rate of complication was clinically and statistically significant.
We closed the loop of the audit cycle and concluded that the use of an absorbable subcuticular suture should be the preferred method of closure of hip wounds in NOF surgery.
The abstracts were prepared by Mr Richard Buxton. Correspondence should be addressed to him at Bankton Cottage, 21 Bankton Park, Kingskettle, Cupar, Fife KY15 7PY, United Kingdom
