Drainage versus Non-Drainage in Total Hip Arthroplasty. A Prospective Randomised Study

Abstract

We present a prospective review of 23 patients having 25 primary total hip arthroplasties (THAs) over a two-month period. Patients were randomly allocated into two groups, one with wound drainage and the other without. There were 12 hips in the Drain group and 13 hips in the No-drain group. Demographic characteristics and risk factors were similar in the two groups. The average wound score (ASEPSIS) was found to be higher for the No-drain group and this was statistically significant. In the No-drain group, 7 out of 13 hips developed infection (5 superficial and 2 deep). In the Drain group, 1 out of 12 hips developed deep infection. The difference in the average drop in the haemoglobin between the two groups was not statistically significant. In the Drain group, the average drainage volume was 463ml. The type of anaesthetic, duration of the operation, experience of the surgeon and the surgical approach used were not found to have a statistically significant correlation with postoperative wound infection. Our small series supports the view that the use of closed suction drainage after THA results in lower incidences of drainage from the wound site and also of wound infection.

Simplified wound care and earlier wound recovery without closed suction drainage in elective total hip arthroplasty. A prospective randomized trial in 100 operations

“…On the other hand, Waugh [21] showed a 1% infection rate in the wounds treated with suction as compared with the 3% infection rate in the control group. Finally, Ravikumar [17] abruptly stopped his study after having a 54% infection rate for the non-drained group compared to 8% in the drained group. In the present study, no superWcial and no deep infections were encountered.…”

“…Results of clinical trials on the use of drains are conXicting and most of them include diVerent surgical procedures into the same study [3,7,20], have a short follow-up [4,12,18] or use small numbers [12,17].…”

Do we really need closed-suction drainage in total hip arthroplasty? A meta-analysis

“…Following the search strategy outlined above, and the inclusion and exclusion criteria, the two independent reviewers located 20 RCTs [3][4][5][6][7][8][9][10][11][12][13][14][15][16][17][18][19][20][21][22] involving 3,186 patients for our analysis ( Table 2). The entire process is shown in Fig.…”

“…Eight studies [3,9,13,17,19,20,22] reported data on postoperative pain. And two of them [11,19] reported that more patients experienced mid-thigh pain in the no-drainage group than in the drainage group, while six [3,9,13,17,20,22] reported no significant difference. Based on the data pooled from Dora et al [17] and Kleinert et al [20], no significant difference of pain could be found between the groups (WMD, −0.09 [95 % CI, −0.63 to 0.44]; p=0.73).…”

“…5). Four studies [6,7,10,11] reported oozing from the wound. The data of the largest number of subjects included in the studies was pooled for analysis.…”