Primary total hip arthroplasty (THA) with or without closed negative suction drain - A comparative study among Indian population

Most of the Closed Suction Drain (CSD) usage is because of prior training. It is believed that post-op CSD decreases ecchymosis and prevents hematoma formation, thereby promote healing of wound by decreasing tension around the wound and increasing tissue blood perfusion in the nearby vicinity. It is believed that CSD is associated with higher levels of blood loss with higher risk of infection. We did a prospective study with 100 patients who were in need of primary total hip arthroplasty after approval from Ethical Comittee. Duration - 6 months. Patients were mobilised, the day after surgery. Drains were removed after 48hrs and appropriate dressing was done. All parameters were documented. Antibiotic were given until drain was insitu.100 patients [70 for the drain group and 30 for the no-drain group] were selected for this study. Infection was noted in 5 patients (4 in drain group and 1 in no drain group). Blood transfusion was done for 18 patients in total, with 14 being from the drain group and 4 from the group without the drain. The mean postop stay was 8.6 days for patients in the group with the CSDs and 7.1 days in the group without the drain. P-value was found to be less than 0.05. We have come to the conclusion that CSDs in THA are associated with a higher blood transfusion rate and longer postop stay in patients. The routine use of CSD is not recommended in THA.