Comparison of clips versus sutures in orthopaedic wound closure

A prospective randomised trial was conducted to compare the use of skin clips versus interrupted nylon sutures in uncomplicated orthopaedic wound closure. Non-blinded wound assessment for complications and outcome (cosmesis) was performed on day 13 when the clips/sutures were removed. Average time for removal of each clip/suture was calculated for each wound. Also, an assessment of patient pain during removal was made using a patient-completed visual analogue scoring system (VAS). No statistically significant difference was found in wound healing and cosmesis between the clip and suture group at follow-up. Clip removal with the special clip remover was found to be quicker and less painful (p=0.001). There was good patient satisfaction with the use of skin clips over nylon sutures. We recommend the use of skin clips, using an assistant to evert the wound edges, as an efficient form of wound closure in most uncomplicated orthopaedic procedures.