Pneumatic wound compression after hip fracture surgery did not reduce postoperative blood transfusion: A randomized controlled trial involving 292 fractures.
OBJECTIVE
Patients with fracture of the proximal femur often undergo blood transfusion. A pneumatic compression bandage has been shown to reduce transfusion after primary hip arthroplasty for osteoarthritis. In this randomized trial, we evaluated the efficacy of this bandage following surgery for hip fracture.


METHODS
288 patients, 50 years or older with 292 fractured hips treated with hemiarthroplasty or internal fixation (except pinning), were randomized to an experimental group with pneumatic wound compression applied after surgery (n = 138) and a control group with the same dressing but no compression (n = 154). Transfusion threshold was blood hemoglobin below 100 g/L. The primary outcome measures were the number of blood units and the proportion of patients transfused after surgery.


RESULTS
The primary outcome measures were similar in both groups. The mean number of postoperatively transfused blood units was 1.3 in the compression group and 1.1 in the non-compression group. Blood transfusion was given to 84 patients (62%) in the compression group and to 85 patients (55%) in the non-compression group.


CONCLUSIONS
Pneumatic wound compression does not reduce the need for transfusion after hip fracture surgery.
Apelqvist
Anna
A
Department of Orthopedics, Hässleholm-Kristianstad, Hässleholm Hospital, Sweden. anna.apelqvist@skane.se
Waldén
Markus
M
Larsson
Gert-Uno
GU
Atroshi
Isam
I
D000368:Aged; D019644:Arthroplasty, Replacement, Hip; D001458:Bandages; D016063:Blood Loss, Surgical / Q000517:prevention & control*; D001803:Blood Transfusion; D005260:Female; D005593:Fracture Fixation, Internal; D006620:Hip Fractures / Q000601:surgery*; D006801:Humans; D008297:Male; D008875:Middle Aged; D017063:Outcome Assessment, Health Care; D019106:Postoperative Hemorrhage / Q000517:prevention & control; D011312:Pressure