Does Draining the Post Operative Hematoma Have an Impact in Tka Patients

Shah, Syed Kamran Ali; Noor, Syed Shahid; Zameer, Mehroze; Najjad, Kazim Rahim; Ghilzai, Asad Khan

doi:10.26717/bjstr.2017.01.000465

Cited by 1 publication

(2 citation statements)

References 11 publications

(12 reference statements)

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“…Our results were consistent with those obtained from recent literature on the application of drains in patients with THA. [ 1 , 13 – 15 ] In our study, we found that the need for blood transfusion in the non-CSSD group is less than that in the CSSD group, which reduces the risk of complications related to blood transfusion. In addition, the changes in Hgb levels in the non-CSSD group were statistically lesser than those in the CSSD group, and we believe that the effect of a tamponade might decrease cutting the medulla and soft tissue bleeding in the non-CSSD group.…”

Section: Discussionmentioning

confidence: 56%

“…In a prospective observational study, 120 patients with total knee arthroplasty (TKA) were randomly assigned even and odd numbers and divided into 2 groups. [ 13 ] They found significant Hgb drops postoperatively in the drain group with an increased number of transfusions than those in the nondrainage group. Suarez et al reported no clinical benefit or disadvantage to closed suction drainage in anterior hip arthroplasty with the concomitant use of tranexamic acid for surgical hemostasis and aspirin for venous thromboembolism prophylaxis.…”

Section: Discussionmentioning

confidence: 99%

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An analysis of the usefulness for using skin adhesive without closed-suction drainage in primary total hip arthroplasty: A retrospective propensity score matched study

Lee,

Jin,

Jeong

et al. 2023

Medicine

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The closed suction surgical drainage system (CSSD) is routinely used after total hip arthroplasty (THA) by orthopedic surgeons in many institutions. However, it has not been shown to decrease the rate of wound infection significantly and may even increase blood loss. This study aimed to evaluate the usefulness of using skin adhesive without CSSD in uncomplicated THA. From July 2015 to September 2017, 200 patients undergoing unilateral THA were enrolled and divided into 2 groups, either receive CSSD (134 patients) or not receive CSSD (66 patients). Then, the propensity matched was performed. Calculated total blood loss, changes in hemoglobin (Hgb) level, transfusions were evaluated. In addition, data on the length of hospital stay, operation time, closure time, time to using crutches following THA were collected. Finally, Harris hip score (HHS), total estimated cost, and complications were assessed. The non-CSSD group had comparatively less blood loss (508.5 ± 280.3 mL compared with 742.1 ± 330.3 mL, P < .001), fewer transfusions (0.03 units compared with 0.3 units, P = .02), less transfusion rate (1.9% compared with 17.3 %, P = .02), lower change of Hgb from immediate postoperative period to 3 days later(1.6 ± 1.0 g/dL compared with 2.0 ± 0.8 g/dL, P = .03), than the CSSD group. There was a longer duration of hospital stay in the CSSD groups (7.2 days compared with 7.8 days, P = .03) The mean total cost in the non-CSSD group was $162.1, which was less than that of the CSSD group, which spent $288.5 on average (P < .001). there was 1 allergic reaction in the non-CSSD group (P = .32). The use of skin adhesive without CSSD could help decrease blood loss, the need for transfusion, and the length of hospital stay, and seems to more cost-effectiveness than using CSSD. It may also provide superior results and allow the patient to recover faster. Using this type of skin adhesive without CSSD is an efficient wound closure method for patients undergoing uncomplicated THA. However, care must be taken for allergic reactions, especially for patients with known or suspected allergies to cyanoacrylate or formaldehyde.

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Section: Discussionmentioning

confidence: 56%

Section: Discussionmentioning

confidence: 99%