title: Is wound drainage necessary in hip arthroplasty? A meta-analysis of randomized controlled trials.
abstract: OBJECTIVE
  The use of closed suction drainage systems for hip arthroplasty (HA) is a common practice. However, the effectiveness and safety are still questionable. Thus, the aim of this meta-analysis was to review the advantages and adverse effects of closed suction drainage systems in hip arthroplasty.
  
  
  METHODS
  All randomized or quasi-randomized trials comparing the use of closed suction drainage systems with no drainage systems for hip arthroplasty were searched in PubMed, Medicine, EMBASE and other internet databases. We assessed the methodological quality of the studies and abstracted the relevant data independently.
  
  
  RESULTS
  Sixteen studies involving 1,663 participants with surgical wounds comparing HA with and without the use of drainage were included in our analysis. Our results demonstrated blood transfusion was required more frequently the same as the persistent discharge in those who received drains. No significant differences in the incidence of wound hematoma, dehiscence or deep vein thrombosis were found between those allocated to drains and the non-drained wounds. Wound infection and the range of movement of the joint after surgery were similar between the two groups.
  
  
  CONCLUSIONS
  Based on the current evidence, there is insufficient evidence to support the routine use of closed suction drainage in hip arthroplasty. At the same time, our meta-analysis study suggested that using of closed suction drainage in HA increased requirement for postoperative blood transfusion. However, there is a moderate possibility of selection bias and publication bias in this review. Because of the limited number of studies which may weaken the strength of the evidence of our results, more samples, high-quality randomized trials are needed to increase the reliability of evidences.
  
  
  METHODS
  II.
authors.affiliation: Department of Orthopedics, Third Hospital of Hebei Medical University, Shijiazhuang, 050051, People's Republic of China.
authors.forename: Zhao-Yu
authors.initials: ZY
authors.lastname: Chen
authors.forename: Yan
authors.initials: Y
authors.lastname: Gao
authors.forename: Wei
authors.initials: W
authors.lastname: Chen
authors.forename: Xu
authors.initials: X
authors.lastname: Li
authors.forename: Ying-Ze
authors.initials: YZ
authors.lastname: Zhang
mesh_terms: D019644:Arthroplasty, Replacement, Hip / Q000009:adverse effects / Q000379:methods*; D001803:Blood Transfusion; D006406:Hematoma / Q000209:etiology; D006621:Hip Joint / Q000503:physiopathology; D006801:Humans; D016032:Randomized Controlled Trials as Topic; D016059:Range of Motion, Articular; D013396:Suction / Q000009:adverse effects; D013530:Surgical Wound Infection / Q000209:etiology; D020246:Venous Thrombosis / Q000209:etiology
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