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General Orthopaedics

NEW STRATEGY OF NEGATIVE SUCTION DRAINAGE MANAGEMENT AFTER PRIMARY TOTAL HIP ARTHROPLASTY

The International Society for Technology in Arthroplasty (ISTA), 28th Annual Congress. PART 2.



Abstract

Purpose

There are still some controversies over the routine use of negative suction drainage after primary total hip arthroplasty (THA). In this study we are to know the benefits of new suction drainage management strategy after primary THA.

Materials and methods

From 2010 to 2012, two hundred patients who had unilateral primary THA were randomly allocated into two groups. One group had negative suction drainage immediately after THA (Group 1). In the other group, the suction drainage was inserted but negative pressure was applied more than 12 hours after surgery, in the morning postoperative day one (Group 2). All surgeries were performed by one single hip surgeon using the same technique and postoperative rehabilitation protocol was all same. We checked the amount of blood loss, changes in hemoglobin (Hb), volume of blood transfusion, superficial or deep wound infection and hematoma. Clinical results were evaluated using HHS score.

Results

The changes in hemoglobin (Hb) from postoperative 48hrs from immediate THA was not different between two groups (group 1: 0.91±1.10, group 2: 0.77±0.95, p=0.334). However, the changes in Hb postoperative day one from immediate was significantly lower in group 2 (group 1: 4.24±1.09, group 2: 3.61±0.96, p<0.001). The changes in Hb from posteroperative day one and seven were significantly lower in group 2 comparing preoperative Hb (group 1: 1.11±1.52, group 2:0.67±1.57, p=0.043). The amount of total blood drainage was different between two groups (group 1: 437.75±193.51, group 2: 377.25±185.19, p<0.001). The unit number of blood transfusion was also significantly lower in group 2 (group 1: 1.40±1.24, group 2: 0.74±1.03, p <0.001). There was no significant difference about the complication rate between two groups. There was no difference in HHS between two groups.

Conclusions

The simple change of negative suction drainage management strategy can reduce the amount of blood loss after primary THA and the volume of blood transfusion.


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