New strategy of closed suction drainage after primary total hip arthroplasty.
OBJECTIVE
The purpose of this study was to evaluate the effect of late applied negative pressure on postoperative drain output after primary total hip arthroplasty (THA).


METHODS
100 patients (100 hips) were treated by closed suction drainage applying negative pressure immediately after THA (group I). The remaining 100 patients (100 hips) were treated by the same drainage system, but the negative pressure was not applied in the first 24 h after THA and then negative pressure was applied (group II).


RESULTS
The mean total drain output was different between the two groups (group I: 597 ± 200.1 mL, group II: 403 ± 204.1 mL; p < 0.05). Reported drain output from immediate postoperative to postoperative day one was 369 ± 125.5 ml in group I and 221 ± 141.3 ml in group II (p < 0.05). The change of hemoglobin from immediate postoperative to 24 h after THA was lower in group II (group I: 1.5 ± 0.62 g/dL, group II: 1.1 ± 0.73 g/dL; p = 0.004). The mean unit number of blood transfusions was 1.0 (range, 0.0-5.0) in group I and 0.3 (range, 0.0-2.0) in group II (p < 0.05). There was no difference in Harris hip score between the two groups at postoperative 1 year or last follow-up (p = 0.073).


CONCLUSIONS
The minor change in drain system management can reduce postoperative blood loss after primary THA and the need for transfusion.


METHODS
Level III, Therapeutic study.
Center for Joint Disease, Chonnam National University Hwasun Hospital, Hwasun-Gun, Republic of Korea.
Gun-Woo
GW
Lee
Center for Joint Disease, Chonnam National University Hwasun Hospital, Hwasun-Gun, Republic of Korea. Electronic address: chiasma@hanmail.net.
Kyung-Soon
KS
Park
Center for Joint Disease, Chonnam National University Hwasun Hospital, Hwasun-Gun, Republic of Korea.
Do-Youn
DY
Kim
Center for Joint Disease, Chonnam National University Hwasun Hospital, Hwasun-Gun, Republic of Korea.
Young-Rok
YR
Shin
Center for Joint Disease, Chonnam National University Hwasun Hospital, Hwasun-Gun, Republic of Korea.
Taek-Rim
TR
Yoon
D000328:Adult; D019644:Arthroplasty, Replacement, Hip / Q000379:methods*; D005260:Female; D005271:Femur Head Necrosis / Q000175:diagnosis / Q000601:surgery*; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D011182:Postoperative Care / Q000592:standards*; D011183:Postoperative Complications / Q000601:surgery*; D011184:Postoperative Period; D017410:Practice Guidelines as Topic; D012189:Retrospective Studies; D013396:Suction / Q000592:standards
Blood loss; Closed suction; Drainage; Total hip arthroplasty; Transfusion