Introduction Evidence to support or refute closed suction drainage (CSD) in primary total hip replacement (THR) is not conclusive. Our anecdotical experience was that persistent ooze from the drainage hole often delayed wound recovery. We hypothesized that, without CSD, wound care would be simpliWed without short or long term disadvantage. Materials and methods Hundred patients scheduled for primary THR were randomly assigned for CSD or non-drainage. Drains were withdrawn at day 2. Pain, wound hematoma, number of dressing changes, time of persistent discharge from the operation site (skin incision and drain hole), total blood loss and number of blood transfusions were prospectively recorded. Hip function, presence of heterotopic ossiWcations (HTO) and complications were recorded at a follow visit 1 year after surgery. Results Wound sites managed without CSD needed signiWcantly less wound dressings (P < 0.001) and were dry at an earlier time (P < 001). Despite a signiWcant bigger subfascial hematoma in the non-drained group (P < 0.05), in terms of pain, thigh swelling, total blood loss, number of transfusions needed, hip function and HTO no diVerence was recorded between the groups (P = 0.2-0.82). Conclusion To omit CSD in primary THR results in simpliWed and more rapid wound management without any disadvantage at short and long term.
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