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SAGE Publications, Hip International, 6(27), p. 564-566, 2017

DOI: 10.5301/hipint.5000501

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A Retained Stitch in Time Saves 9 - But Does it Increase the Risk of Deep Prosthetic Infection?

Journal article published in 2017 by Bola Akinola, Ben Quansah, Theodore Gouliouris ORCID, Andrew D. Carrothers
This paper is made freely available by the publisher.
This paper is made freely available by the publisher.

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Abstract

Introduction During the posterior approach to the hip, the short external rotators are detached and secured with stay sutures. At the time of definitive closure, some surgeons incorporate the initial sutures into their repair while others discard for fresh sutures, presumably as an infection prevention measure. We have conducted a pilot study to investigate whether the incorporation of the primary stay sutures may constitute an infection risk to the patient undergoing a total hip replacement through the posterior approach. Materials and methods The pilot study was conducted between August 2014 and June 2015. A pair of suture specimens were sent from 25 patients to microbiology, 1 set of primary stay sutures and 1 set of control sutures. All operations were carried out by the senior author through a posterior approach. Results All specimens were analysed for bacterial and fungal growth, using extended cultures. 1 set of primary sutures had a positive growth, likely from skin contamination; 1 set of control sutures also had a positive growth, likely from environmental contamination. Conclusions Our pilot study suggests that the practice of incorporating the primary stay sutures for definitive soft tissue repair of the short external rotators, rather than exchanging them for new sutures, can be deemed safe.