Closed suction drainage has no benefits in revision total hip arthroplasty: a randomized controlled trial.
OBJECTIVE
Several studies have failed to show significant benefits of closed suction drainage (CSD) in routine primary total hip arthroplasty (THA). However, blood loss, haematoma formation and wound complications are generally much greater in revision THA as compared to primary THA. The purpose of this study was to determine if CSD is beneficial for revision THA patients.


METHODS
We conducted a prospective, randomized, controlled trial at our institution between July 2013 and July 2014. Eighty-eight patients undergoing revision THA were enrolled and randomly assigned to receive a CSD (n = 44) or to not receive a CSD (n = 44). All first-stage revision surgeries for infection were excluded. Primary outcomes were haemoglobin loss and number of patients transfused. Secondary outcomes included functional outcome evaluated with Harris hip score (HHS), pain evaluated with visual analogue scale (VAS), and length of hospital stay.


RESULTS
There were significantly more patients in the CSD group that required blood transfusions (20/44 as compared to 11/44, p = 0.04). Patients in the no CSD group were discharged earlier than patients in the CSD group (4.3 days as compared to 5.4 days, p = 0.002). No statistical significant difference was found in the HHS or pain VAS between the groups.


CONCLUSIONS
This study did not demonstrate any benefit with the use of CSD for revision THA with regard to wound related complications, infection or early functional outcome. Post-operative blood loss, transfusion rate, and length of hospital stay may be higher with CSD.
Mount Sinai Hospital, Division of Orthopaedic Surgery, University of Toronto, 600 University Avenue, Toronto, ON, M5G 1X5, Canada.
Simcha G
SG
Fichman
Mount Sinai Hospital, Division of Orthopaedic Surgery, University of Toronto, 600 University Avenue, Toronto, ON, M5G 1X5, Canada. tatu.makinen@hus.fi.
Tatu J
TJ
Mäkinen
Mount Sinai Hospital, Division of Orthopaedic Surgery, University of Toronto, 600 University Avenue, Toronto, ON, M5G 1X5, Canada.
Benjamin
B
Lozano
Mount Sinai Hospital, Division of Orthopaedic Surgery, University of Toronto, 600 University Avenue, Toronto, ON, M5G 1X5, Canada.
Wael A
WA
Rahman
Mount Sinai Hospital, Division of Orthopaedic Surgery, University of Toronto, 600 University Avenue, Toronto, ON, M5G 1X5, Canada.
Oleg
O
Safir
Mount Sinai Hospital, Division of Orthopaedic Surgery, University of Toronto, 600 University Avenue, Toronto, ON, M5G 1X5, Canada.
Allan E
AE
Gross
Mount Sinai Hospital, Division of Orthopaedic Surgery, University of Toronto, 600 University Avenue, Toronto, ON, M5G 1X5, Canada.
David
D
Backstein
Mount Sinai Hospital, Division of Orthopaedic Surgery, University of Toronto, 600 University Avenue, Toronto, ON, M5G 1X5, Canada.
Paul R T
PR
Kuzyk
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D019644:Arthroplasty, Replacement, Hip; D001803:Blood Transfusion; D005260:Female; D006801:Humans; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D010147:Pain Measurement; D019106:Postoperative Hemorrhage / Q000209:etiology; D011446:Prospective Studies; D012086:Reoperation; D013396:Suction / Q000379:methods*
Blood loss; Closed suction drain; Hip; Revision arthroplasty