Closure of hip wound, clips or subcuticular sutures: does it make a difference?

The purpose of this study was to investigate wound healing and complications following surgery for fracture neck of femur. Seventy-one patients were prospectively divided into two groups, according to the method of skin closure: group A had clips; group B had subcuticular vicryl® sutures. There were 41 patients in group A, and 30 patients in group B. There were 13 males and 58 females with an average age of 84.3 years (range 67-100 years). Thirty-seven patients underwent fixation with a dynamic hip screw, while 34 had undergone either a hemi or total hip arthroplasty. The wounds were inspected at days 2, 5, 7, 10 and 14 days, for discharge, redness and infection. There was a statistically significantly greater amount of wound discharge (P<0.002) and redness (P<0.009) in group A (clips) as compared to group B (vicryl). There were three cases of infection; all in patients where clips had been used for skin closure. We concluded that subcuticular vicryl sutures were significantly better than clips in terms of wound healing as well as cost. Except for some decrease in operative time there does not seem to be any advantage in the use of clips for wound closure.