Hip DAA Closure Techniques

Study Overview
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Brief Summary
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This study aims to analyze the difference in rates of wound complications using two different closure techniques in Direct anterior approach for primary total hip replacement.

Detailed Description
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The use of the direct anterior approach (DAA) for primary total hip arthroplasty (THA) has been increasingly popular but there has been a reported increased risk of wound complications compared with a posterior approach. Wound complications can lead to increased length of stay, reoperation procedures (i.e., irrigation and debridement), patient dissatisfaction, extra visits, readmissions, increased risk of periprosthetic joint infection and overall increased costs.

Official Title
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Direct Anterior Approach of the Hip and Variations in Wound Complications Using Different Closure Techniques

Conditions
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Total Hip Replacement, Wound Complication

Intervention / Treatment
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* Procedure: wound closure subcuticular running stitch using 3-0 monocryl suture without skin adhesive
* Procedure: wound closure subcuticular running stitch using 3-0 monocryl suture with two layers of skin adhesive


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Patients older than 18 years old that will undergo THA via DAA Exclusion Criteria: Previous hip arthroplasty surgeries or scars THA secondary to oncologic or traumatic etiologies BMI ≥ 40 uncontrolled diabetes (measured by a Hgb A1c above 8) reported allergy to skin adhesive

Ages Eligible for Study
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Minimum Age: 18 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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Accepts Healthy Volunteers

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Treatment
Allocation: Non-Randomized
Intervention Model: Crossover Assignment
Masking: None (Open Label)


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Active Comparator: wound closure subcuticular running stitch using 3-0 monocryl suture without skin adhesive<br>After surgery, the closure technique utilized by the surgeons will be wound closure subcuticular running stitch using 3-0 monocryl suture without skin adhesive | Procedure: wound closure subcuticular running stitch using 3-0 monocryl suture without skin adhesive<br>* wound closure subcuticular running stitch using 3-0 monocryl suture without skin adhesive<br>|
| Active Comparator: wound closure subcuticular running stitch using 3-0 monocryl suture with two layers of skin adhesive<br>After surgery, the closure technique utilized by the surgeons will be wound closure subcuticular running stitch using 3-0 monocryl suture with two layers of skin adhesive | Procedure: wound closure subcuticular running stitch using 3-0 monocryl suture with two layers of skin adhesive<br>* wound closure subcuticular running stitch using 3-0 monocryl suture with two layers of skin adhesive<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Wound complications | Assessed using photographic documentation of the wound | 90 days | 
| Participant satisfaction | assessed using the POSAS (patient and observer scar assessment scale) questionnaire | 90 days |