Consensus document on the management of wound closure in orthopaedic surgery

Abstract

Wounds in orthopaedic surgery differ from wounds in other surgical fields in various ways. Tissues that are highly affected due to the trauma itself, the presence of an orthopaedic implant and the performance of prosthetic surgery in patients with many comorbidities make these wounds need special consideration. Complications of the surgical wound in orthopaedic surgery are not unusual, being the main cause of medical care and readmission in the first 90 days. There is no consensus on the best way to perform closure in orthopaedic surgery. The national 'Adequate Wound Management in Orthopaedic Surgery' survey has shown interindividual variability in wound closure and soft tissue management in orthopaedic surgery at the local level. This consensus document, generated by a group of experts in soft tissue management in orthopaedic surgery, proposes recommendations based on evidence (using the GRADE methodology) to promote best practices in this field. This document considers recommendations for surgical wound closure, dressing management and haemostasis. In addition, some of the 32 questions in the national survey, plus others relevant to the subject, were taken as a starting point for developing the contents.