The impact of different methods of wound closure and dressing on the rate of wound infection in patients with fracture of the neck of femur

Abstract

Summary A prospective, pilot study was conducted to compare infection rates in four groups with different methods of wound closure and dressing among a convenience sample ( n =65) of patients with a fracture of the neck of femur. The four groups were: Clips with Mepore dressing (n=25) Subcuticular suture with Mepore (n=11) Clips with Opsite dressing (n=16) Subcuticular suture with Opsite (n=13) There were a total of 65 participants (5 males and 60 females) with ages ranging from 70 to 103 years (mean=86, sd=5.7). Patients were followed during their stay on the ward. The four groups were evaluated with respect to infection rates. Gross purulent discharge, dehiscence, or purulent discharge from a single suture was considered a wound infection and this was confirmed microbiologically. Infection was noted in 6/25 (24%) of cases in which clips were used with Mepore dressing as compared to 1/11 (9%) when subcuticular sutures and Mepore were used. Infection rates for clips and Opsite, and subcuticular and Opsite were 2/16 (12.5%) and zero, respectively. Statistically there was no difference in infection rates between Mepore dressing and either type of skin closure ( p =0.4) and similarly for Opsite and either skin closure type ( p =0.48). The authors feel that the methods of wound closure and type of dressing probably have no additional benefit for the prevention of wound infection rate among elderly patients with fractures of the neck of femur, and that a larger randomized controlled study would be useful.