Wound Closure Materials and Techniques in Hip and Knee Arthroplasty

Evaluation of Different Suture Materials and Closure Techniques in Lower Extremity Arthroplasty: Effects on Wound Healing, Functional Outcomes, and Complications

This prospective randomized clinical study aims to evaluate the effects of different suture materials and wound closure techniques on wound healing, functional outcomes, and postoperative complications in patients undergoing total hip and knee arthroplasty.

A total of at least 90 adult patients undergoing primary or aseptic revision lower extremity arthroplasty will be randomized into two groups according to the wound closure material and technique used. All surgeries will be performed by the same surgical team following standardized operative protocols.

Primary outcomes include wound-related complications such as prolonged wound drainage, wound dehiscence, surgical site infection, and local inflammatory findings within 90 days postoperatively. Secondary outcomes include operative time, bleeding amount, cosmetic outcomes, and functional scores.

The results of this study are expected to help determine the most effective and safe wound closure method in lower extremity arthroplasty.

Study Overview

• Status: Recruiting
• Conditions: Osteoarthritis, Knee; Osteoarthritis, Hip
• Intervention / Treatment: Procedure: Barbed Suture Wound Closure; Procedure: Conventional Suture Wound Closure

Detailed Description

Total hip and knee arthroplasty are commonly performed surgical procedures in the management of end-stage degenerative joint diseases. Optimal wound closure is critical in reducing postoperative complications such as prolonged wound drainage, wound dehiscence, surgical site infection, and delayed wound healing. Various suture materials and closure techniques are routinely used in clinical practice; however, consensus regarding the most effective method remains limited.

This prospective randomized study is designed to compare different suture materials and wound closure techniques in patients undergoing primary or aseptic revision total hip and knee arthroplasty. Participants will be randomly assigned in a 1:1 ratio to one of two wound closure strategies differing in both suture material and closure technique following total hip or knee arthroplasty. The study aims to determine their effects on wound healing, functional outcomes, and postoperative complications.

A minimum of 90 adult patients will be enrolled. Eligible patients will be randomized into two groups according to the wound closure material and technique used. All surgical procedures will be performed by the same surgical team following standardized perioperative protocols in order to minimize confounding variables.

Preoperative demographic data will be recorded. Intraoperative variables including operative time and intraoperative blood loss will be documented. Postoperative assessments will include wound drainage duration, signs of local inflammation, wound dehiscence, surgical site infection, bleeding complications, and cosmetic evaluation. Functional outcomes will be assessed using validated hip and knee scoring systems where applicable.

Patients will be followed for 90 days postoperatively. All data will be recorded in a secure database and analyzed using appropriate statistical methods. Continuous variables will be assessed for normal distribution and analyzed using parametric or non-parametric tests as appropriate. Categorical variables will be analyzed using Chi-square or Fisher's exact test. Multivariate logistic regression analysis will be performed to identify independent predictors of wound-related complications. A p-value < 0.05 will be considered statistically significant.

The findings of this study are expected to contribute to the optimization of wound closure strategies in lower extremity arthroplasty and improve postoperative outcomes.

• Study Type: Interventional
• Enrollment (Estimated): 90
• Phase: Not Applicable

Contacts and Locations

• Study Contact: Name: Bahattin Kemah, MD; Phone Number: +905337198121; Email: bahattinkemah.md@gmail.com

Study Locations

• Turkey (Türkiye)
  • Istanbul
    • Istanbul, Istanbul, Turkey (Türkiye), 34764
      • Recruiting
      • Ümraniye Training and Research Hospital

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: Adult; Older Adult
• Accepts Healthy Volunteers: No

Description

Inclusion Criteria:

• Age ≥ 30 years
• Patients undergoing primary total hip arthroplasty or total knee arthroplasty
• Patients undergoing aseptic revision total hip or knee arthroplasty
• Surgery performed by the same surgical team
• Ability to provide informed consent

Exclusion Criteria:

• Age < 30 years
• Patients receiving immunosuppressive therapy
• Patients with complicated diabetes mellitus
• Chronic venous insufficiency
• Peripheral arterial disease
• Arthroplasty performed due to malignancy
• Active or previous surgical site infection

Study Plan

How is the study designed?

Design Details

• Primary Purpose: Treatment
• Allocation: Randomized
• Interventional Model: Parallel Assignment
• Masking: None (Open Label)

Number of Arms

2

Arms and Interventions

Participant Group / Arm	Intervention / Treatment
Experimental: Barbed Suture Group; Patients undergoing total hip or knee arthroplasty in whom wound closure is performed using barbed suture material and continuous closure technique.	Procedure: Barbed Suture Wound Closure; Wound closure using barbed suture material with continuous technique following total hip or knee arthroplasty.
Active Comparator: Conventional Suture Group; Patients undergoing total hip or knee arthroplasty in whom wound closure is performed using conventional suture material and standard closure technique.	Procedure: Conventional Suture Wound Closure; Wound closure using conventional suture material with interrupted or standard closure technique following total hip or knee arthroplasty.

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Incidence of wound-related complications within 90 days postoperatively	Wound-related complications include prolonged wound drainage, wound dehiscence, surgical site infection, and local inflammatory findings occurring within 90 days following total hip or knee arthroplasty.	Within 90 days after surgery

Secondary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Operative Time	Duration of surgery measured in minutes from skin incision to wound closure.	Intraoperative (Day of surgery)
Intraoperative Blood Loss	Estimated blood loss measured in milliliters during surgery.	Intraoperative (Day of surgery)
Duration of Postoperative Wound Drainage	Number of days with visible wound drainage after surgery.	Within 90 days after surgery
Surgical Site Infection Rate	Incidence of superficial or deep surgical site infection diagnosed according to clinical criteria within 90 days postoperatively.	Within 90 days after surgery
Wound Dehiscence	Incidence of partial or complete wound separation within 90 days postoperatively.	Within 90 days after surgery
Functional Outcome Score	Functional outcomes will be assessed using the Harris Hip Score (HHS) (range 0-100, with 100 indicating best possible function; higher scores indicate better clinical outcomes) for patients undergoing total hip arthroplasty, and the Knee Society Score (KSS) (range 0-100, with 100 indicating best possible function; higher scores indicate better clinical outcomes) for patients undergoing total knee arthroplasty.	Preoperatively and at 3 months postoperatively

Collaborators and Investigators

• Sponsor: Bahattin Kemah
• Investigators: Principal Investigator: Bahattin Kemah, MD, Umraniye Education and Research Hospital

Study record dates

Study Major Dates

• Study Start (Actual): November 1, 2025
• Primary Completion (Estimated): August 1, 2026
• Study Completion (Estimated): August 1, 2026

Study Registration Dates

• First Submitted: February 23, 2026
• First Submitted That Met QC Criteria: February 23, 2026
• First Posted (Actual): February 27, 2026

Study Record Updates

• Last Update Posted (Actual): March 2, 2026
• Last Update Submitted That Met QC Criteria: February 26, 2026
• Last Verified: February 1, 2026

More Information

Terms related to this study

• Keywords: Arthroplasty; Surgical Site Infection; Wound Healing; Total Knee Arthroplasty; Total Hip Arthroplasty; Wound Closure; Barbed Suture
• Additional Relevant MeSH Terms: Musculoskeletal Diseases; Postoperative Complications; Pathologic Processes; Arthritis; Joint Diseases; Rheumatic Diseases; Infections; Osteoarthritis; Wound Infection; Pathological Conditions, Signs and Symptoms; Osteoarthritis, Knee; Surgical Wound Infection; Osteoarthritis, Hip
• Other Study ID Numbers: WOMBAT-2025

Plan for Individual participant data (IPD)

• Plan to Share Individual Participant Data (IPD)?: NO
• IPD Plan Description: Individual participant data will not be shared to protect patient confidentiality and comply with institutional policies.

Drug and device information, study documents

• Studies a U.S. FDA-regulated drug product: No
• Studies a U.S. FDA-regulated device product: No