title: Simplified wound care and earlier wound recovery without closed suction drainage in elective total hip arthroplasty. A prospective randomized trial in 100 operations.
abstract: BACKGROUND
  Evidence to support or refute closed suction drainage (CSD) in primary total hip replacement (THR) is not conclusive. Our anecdotical experience was that persistent ooze from the drainage hole often delayed wound recovery. We hypothesized that, without CSD, wound care would be simplified without short or long term disadvantage.
  
  
  METHODS
  Hundred patients scheduled for primary THR were randomly assigned for CSD or non-drainage. Drains were withdrawn at day 2. Pain, wound hematoma, number of dressing changes, time of persistent discharge from the operation site (skin incision and drain hole), total blood loss and number of blood transfusions were prospectively recorded. Hip function, presence of heterotopic ossifications (HTO) and complications were recorded at a follow visit 1 year after surgery.
  
  
  RESULTS
  Wound sites managed without CSD needed significantly less wound dressings (P < 0.001) and were dry at an earlier time (P < 001). Despite a significant bigger subfascial hematoma in the non-drained group (P < 0.05), in terms of pain, thigh swelling, total blood loss, number of transfusions needed, hip function and HTO no difference was recorded between the groups (P = 0.2-0.82).
  
  
  CONCLUSIONS
  To omit CSD in primary THR results in simplified and more rapid wound management without any disadvantage at short and long term.
authors.affiliation: Department of Orthopedic Surgery, Balgrist Clinic, University of Zürich, Forchstrasse 340, 8008, Zürich, Switzerland. claudio.dora@balgrist.ch
authors.forename: Claudio
authors.initials: C
authors.lastname: Dora
authors.forename: Arndt
authors.initials: A
authors.lastname: von Campe
authors.forename: Bernhard
authors.initials: B
authors.lastname: Mengiardi
authors.forename: Peter
authors.initials: P
authors.lastname: Koch
authors.forename: Patrick
authors.initials: P
authors.lastname: Vienne
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D019644:Arthroplasty, Replacement, Hip; D001458:Bandages / Q000706:statistics & numerical data; D004322:Drainage; D005205:Fascia; D005260:Female; D006406:Hematoma / Q000209:etiology; D006801:Humans; D008297:Male; D008875:Middle Aged; D011182:Postoperative Care / Q000379:methods*; D011183:Postoperative Complications; D011446:Prospective Studies; D013396:Suction; D014945:Wound Healing