New strategy of closed suction drainage after primary total hip arthroplasty Gun-Woo Lee, Kyung-Soon Park, Do-Youn Kim, Young-Rok Shin, Taek-Rim Yoon Center for Joint Disease, Chonnam National University Hwasun Hospital, Hwasun-Gun, Republic of Korea

Abstract

Objective: The purpose of this study was to evaluate the effect of late applied negative pressure onpostoperative drain output after primary total hip arthroplasty (THA).Patients and methods: 100 patients (100 hips) were treated by closed suction drainage applying negativepressure immediately after THA (group I). The remaining 100 patients (100 hips) were treated by thesame drainage system, but the negative pressure was not applied in theŞrst 24 h after THA and thennegative pressure was applied (group II).Results: The mean total drain output was different between the two groups (group I: 597± 200.1 mL,group II: 403± 204.1 mL; p < 0.05). Reported drain output from immediate postoperative to postoperative day one was 369± 125.5 ml in group I and 221 ± 141.3 ml in group II (p < 0.05). The change ofhemoglobin from immediate postoperative to 24 h after THA was lower in group II (group I:1.5± 0.62 g/dL, group II: 1.1 ± 0.73 g/dL; p ¼ 0.004). The mean unit number of blood transfusions was 1.0(range, 0.0e5.0) in group I and 0.3 (range, 0.0e2.0) in group II (p < 0.05). There was no difference inHarris hip score between the two groups at postoperative 1 year or last follow-up (p¼ 0.073).Conclusion: The minor change in drain system management can reduce postoperative blood loss afterprimary THA and the need for transfusion.Level of evidence: Level III, Therapeutic study© 2017 Turkish Association of Orthopaedics and Traumatology. Publishing services by Elsevier B.V. This isan open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/).