Postoperative autologous blood transfusion drain or no drain in primary total hip arthroplasty? A randomised controlled trial.
OBJECTIVE
Postoperative maintenance of high haemoglobin (Hb) levels and avoidance of homologous blood transfusions is important in total hip arthroplasty (THA). The introduction of a postoperative drainage autologous blood transfusion (ABT) system or no drainage following THA has resulted in reduction of homologous blood transfusion requirements compared with closed-suction drains. The purpose of this study was to examine which regimen is superior following THA.


METHODS
A randomised controlled blinded prospective single-centre study was conducted in which 100 THA patients were randomly allocated to ABT or no drainage. The primary endpoint was the Hb level on the first postoperative day.


RESULTS
The postoperative collected drained blood loss was 274 (±154) ml in the ABT group, of which 129 (±119) ml was retransfused (0-400). There was no statistical difference in Hb levels on the first postoperative day (ABT vs no drainage: Hb 11.0 vs 10.9 g/dl), on consecutive days (day 3: Hb 10.7 vs 10.2, p = 0.08) or in total blood loss (1,506 vs 1,633 ml), homologous transfusions, pain scores, Harris Hip Score, SF-36 scores, length of hospital stay or adverse events.


CONCLUSIONS
The use of a postoperative autologous blood retransfusion drain did not result in significantly higher postoperative Hb levels or in less total blood loss or fewer homologous blood transfusions compared with no drain.
Kennemer Gasthuis, Haarlem, The Netherlands. wghorstmann@kg.nl
Wieger G
WG
Horstmann
Bart M
BM
Kuipers
Rob
R
Slappendel
Rene M
RM
Castelein
Boudewijn J
BJ
Kollen
Cees C P M
CC
Verheyen
D000368:Aged; D019644:Arthroplasty, Replacement, Hip / Q000009:adverse effects*; D016063:Blood Loss, Surgical / Q000517:prevention & control*; D001803:Blood Transfusion; D001804:Blood Transfusion, Autologous / Q000379:methods*; D004311:Double-Blind Method; D004322:Drainage / Q000379:methods*; D005260:Female; D006621:Hip Joint / Q000503:physiopathology / Q000601:surgery; D006801:Humans; D007592:Joint Diseases / Q000503:physiopathology / Q000601:surgery; D008297:Male; D010147:Pain Measurement; D011182:Postoperative Care / Q000379:methods*; D011183:Postoperative Complications / Q000209:etiology / Q000517:prevention & control; D011184:Postoperative Period; D011446:Prospective Studies; D016896:Treatment Outcome