Aim of the study: Due to the fact, that there is no publication in Medline available concerning the influence of external compression of the wound area after total hip arthroplasty we started a prospective, randomised study to evaluate this effect.

Materials and Methods: In a prospective randomised study including primary total hip replacements we compared 2 different prefabricated compression bandages, maintaining different levels of pressure on the wound area(Group A, B), a group with circular semi elastic bandages (group C) and a group without any bandage (group D). The sample calculated for each group was 130 Patients (level of significance 0.05, power 90%). Parameters concerning postoperative blood loss (haematocrit, need of blood units, blood in drainage) and wound heeling (bleeding of wound area, secretion, haematoma, additional need of antibiotics) were measured. For statistical evaluations Chi²-Test and T-Test were used.

Results: The group using semi elastic, circular bandages (C ) had to be stopped after 13 patients due to non-compliance of more than 50% of the patients because of discomfort and skin lesions. Without compression bandage the frequency of re-operations due to early septic complications was statistically significant higher than in groups using external compression. In the groups B and D the rates of wound secretion have been significantly higher than in group A using high pressure bandages. Duration and quantity of secretion, need of additional antibiotics as well as subcutaneous haematoma were increasing by decreasing external compression. The amounts of blood in Redon drainage were significantly reduced by external compression. In regard to the need of blood units no statistical differences could be detected.

Conclusion: Sufficient compression bandages are able to significantly reduce the frequency of re-operations due to septic complications and support wound healing after total hip arthroplasty. A remarkable number of insufficient products are sold on the market.