BACKGROUND: At present, most of the literature on joint replacement focus on the causes and countermeasures of long-term complications, but seldom focuses on causes of postoperative short-term complications, such as wound exudation and delayed union. Whether the incidence of sustained exudation and delayed wound healing in patients with hypertension after hip replacement is higher than that in patients with normal blood pressure is not reported at present.OBJECTIVE: To identify the correlation of hypertension with persistent wound exudation and delayed wound healing in patients after femoral head replacement.METHODS: Data of 205 elderly patients with femoral neck fractures were retrospectively analyzed. All patients underwent femoral head replacement. In accordance with the hypertension diagnostic criteria of 2010 Chinese Guidelines for the Management of Hypertension, patients were divided into hypertension group and control group.Intraoperative blood loss, postoperative blood loss, the days of prolonged wound exudation, the wound dehiscence, and the prevalence of delayed wound healing were compared between the two groups. Then, we analyzed the relationship of hypertension with wound exudation and delayed wound healing.RESULTS AND CONCLUSION: (1) The average systolic blood pressures were 153.55 mmHg and 128.82 mmHg in the hypertension and control groups, respectively (P < 0.05). (2) No significant difference in age, gender, MNA-SF score, diabetes, body mass index, intraoperative blood loss, and postoperative blood loss was found between the two groups (P > 0.05). (3) The time of persistent wound exudation was 4.03 days and 2.08 days in the hypertension group and control group, respectively (P < 0.05). (4) The prevalence of delayed wound healing was significantly higher in the hypertension group than that in the control group (P < 0.05). (5) Hypertensive patients had a higher risk of prolonged wound exudation and delayed healing than their normotensive counterparts, and the hypertension is one of the important influence factors for delayed wound healing.