New strategy of closed suction drainage after primary total hip arthroplasty Gun-Woo Lee, Kyung-Soon Park, Do-Youn Kim, Young-Rok Shin, Taek-Rim Yoon Center for Joint Disease, Chonnam National University Hwasun Hospital, Hwasun-Gun, Republic of Korea

Objective: The purpose of this study was to evaluate the effect of late applied negative pressure onpostoperative drain output after primary total hip arthroplasty (THA).Patients and methods: 100 patients (100 hips) were treated by closed suction drainage applying negativepressure immediately after THA (group I). The remaining 100 patients (100 hips) were treated by thesame drainage system, but the negative pressure was not applied in theŞrst 24 h after THA and thennegative pressure was applied (group II).Results: The mean total drain output was different between the two groups (group I: 597± 200.1 mL,group II: 403± 204.1 mL; p < 0.05). Reported drain output from immediate postoperative to postoperative day one was 369± 125.5 ml in group I and 221 ± 141.3 ml in group II (p < 0.05). The change ofhemoglobin from immediate postoperative to 24 h after THA was lower in group II (group I:1.5± 0.62 g/dL, group II: 1.1 ± 0.73 g/dL; p ¼ 0.004). The mean unit number of blood transfusions was 1.0(range, 0.0e5.0) in group I and 0.3 (range, 0.0e2.0) in group II (p < 0.05). There was no difference inHarris hip score between the two groups at postoperative 1 year or last follow-up (p¼ 0.073).Conclusion: The minor change in drain system management can reduce postoperative blood loss afterprimary THA and the need for transfusion.Level of evidence: Level III, Therapeutic study© 2017 Turkish Association of Orthopaedics and Traumatology. Publishing services by Elsevier B.V. This isan open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/).

___

1. Zeng WN, Zhou K, Zhou ZK, et al. Comparison between drainage and nondrainage after total hip arthroplasty in Chinese subjects. Orthop Surg. 2014;6: 28e32.

2. Waugh TR, Stinchfield FE. Suction drainage of orthopaedic wounds. J Bone Jt Surg Am. 1961;43:939e946.

3. Murphy JP, Scott JE. The effectiveness of suction drainage in total hip arthroplasty. J R Soc Med. 1993;86:388e389.

4. Willett KM, Simmons CD, Bentley G. The effect of suction drains after total hip replacement. J Bone Jt Surg Br. 1988;70:607e610.

5. Kim YH, Cho SH, Kim RS. Drainage versus nondrainage in simultaneous bilateral total hip arthroplasties. J Arthroplasty. 1998;13:156e161.

6. Cao JG, Wang L, Liu J. The use of clamped drainage to reduce blood loss in total hip arthroplasty. J Orthop Surg Res. 2015;25:10.

7. Yoon TR, Bae BH, Choi MS. A modified two-incision minimally invasive total hip arthroplasty: technique and short-term results. Hip Int. 2006;16(Suppl 4): 28e34.

8. Harris WH. Traumatic arthritis of the hip after dislocation and acetabular fractures: treatment by mold arthroplasty. An end-result study using a new method of result evaluation. J Bone Jt Surg Am. 1969;51:737e755.

9. Zhou XD, Li J, Xiong Y, Jiang LF, Li WJ, Wu LD. Do we really need closed-suction drainage in total hip arthroplasty? A meta-analysis. Int Orthop. 2013;37: 2109e2118.

10. Widman J, Jacobsson H, Larsson SA, Isacson J. No effect of drains on the postoperative hematoma volume in hip replacement surgery: a randomized study using scintigraphy. Acta Orthop Scand. 2002;73:625e629.

11. Gonzalez Della Valle A, Slullitel G, Vestri R, Comba F, Buttaro M, Piccaluga F. No need for routine closed suction drainage in elective arthroplasty of the hip: a prospective randomized trial in 104 operations. Acta Orthop Scand. 2004;75: 30e33.

12. Walmsley PJ, Kelly MB, Hill RM, Brenkel I. A prospective, randomised, controlled trial of the use of drains in total hip arthroplasty. J Bone Jt Surg Br. 2005;87:1397e1401.

13. Hallstrom BR, Steele JF. Postoperative course after total hip arthroplasty: wound drainage versus no drainage. Orthop Rev. 1992;21:847e851.

14. Li N, Li P, Liu M, Wang D, Xia L. Comparison between autologous blood transfusion drainage and no drainage/closed-suction drainage in primary total hip arthroplasty: a meta-analysis. Arch Orthop Trauma Surg. 2014;134: 1623e1631.

15. Wei W, Wei B. Comparison of topical and intravenous tranexamic acid on blood loss and transfusion rates in total hip arthroplasty. J Arthroplast. 2014;29: 2113e2116.

16. Bedair H, Yang J, Dwyer MK, McCarthy JC. Preoperative erythropoietin alpha reduces postoperative transfusions in THA and TKA but may not be costeffective. Clin Orthop Relat Res. 2015;473:590e596.

17. Brueggemann PM, Tucker JK, Wilson P. Intermittent clamping of suction drains in total hip replacement reduces postoperative blood loss: a randomized, controlled trial. J Arthroplast. 1999;14:470e472.
Acta Orthopaedica et Traumatologica Turcica-Cover
  • ISSN: 1017-995X
  • Başlangıç: 2015
  • Yayıncı: Türk Ortopedi ve Travmatoloji Derneği
Sayıdaki Diğer Makaleler

A comparison of short term radiological alignment outcomes of the patient speciŞc and standard instrumentation for primary total knee arthroplasty: A systematic review and meta-analysis

Ilhan ALCELİKA, Mark BLOMŞELDA, Cenk OZTÜRKB, Ashish SONİ, Richard CHARİTYC, Alex ACORNLEYC

Partial quadriceps tendon transfer for revision medial patellofemoral ligament reconstruction: A new surgical technique

Joan LEAL-BLANQUET, Eduard ALENTORN-GELI, Raúl TORRES-CLARAMUNT, Joan Carles MONLLAU

Evaluation of vitamin D levels in patients with chronic low back-leg pain

Yalkın ÇALIK, Ümit AYGÜN

FROM THE EDITOR Dear AOTT Readers

Önder KILIÇOĞLU

Relationship between the mobility of medial longitudinal arch and postural control

TANSU BİRİNCİ, FEYZA ŞULE BADILLI DEMİRBAŞ

New strategy of closed suction drainage after primary total hip arthroplasty Gun-Woo Lee, Kyung-Soon Park, Do-Youn Kim, Young-Rok Shin, Taek-Rim Yoon Center for Joint Disease, Chonnam National University Hwasun Hospital, Hwasun-Gun, Republic of Korea

Gun-Woo LEE, Kyung-Soon PARK, Do-Youn KİM, Young-Rok SHİN, Taek-Rim YOON

Biomechanical analysis of the fixation systems for anterior column and posterior hemi-transverse acetabular fractures

Jianyin LEİ, Pengfei DONG, Zhiqiang Lİ, Feng ZHU, Zhihua WANG, Xianhua CAİ

Bilateral bony increased-offset reverse shoulder arthroplasty in rheumatoid arthritis shoulder with severe glenoid bone defect: A case report

Wan-Sun CHOI, Kwang-Hyun LEE, Jin-Sung PARK, Bong Gun LEE

Anterior cervical fusion with interbody cage containing beta-tricalcium phosphate: Clinical and radiological results

Ali Ender OFLUOĞLU, Uzay ERDOĞAN, Mehmet AYDOĞAN, Orhun Mete CEVİK, Önder OFLUOĞLU

Influence of the different anteromedial portal on femoral tunnel orientation during anatomic ACL reconstruction

Dong-Kyu MOON, Ho-Seung JO, Dong-Yeong LEE, Dong-Geun KANG, June-Ho BYUN, Sun-Chul HWANG