• Claudio Dora, Arndt von Campe, Bernhard Mengiardi, Peter Koch, and Patrick Vienne.
• Department of Orthopedic Surgery, Balgrist Clinic, University of Zürich, Forchstrasse 340, 8008, Zürich, Switzerland. claudio.dora@balgrist.ch
• Arch Orthop Trauma Surg. 2007 Dec 1;127(10):919-23.

IntroductionEvidence to support or refute closed suction drainage (CSD) in primary total hip replacement (THR) is not conclusive. Our anecdotical experience was that persistent ooze from the drainage hole often delayed wound recovery. We hypothesized that, without CSD, wound care would be simplified without short or long term disadvantage.Materials And MethodsHundred patients scheduled for primary THR were randomly assigned for CSD or non-drainage. Drains were withdrawn at day 2. Pain, wound hematoma, number of dressing changes, time of persistent discharge from the operation site (skin incision and drain hole), total blood loss and number of blood transfusions were prospectively recorded. Hip function, presence of heterotopic ossifications (HTO) and complications were recorded at a follow visit 1 year after surgery.ResultsWound sites managed without CSD needed significantly less wound dressings (P < 0.001) and were dry at an earlier time (P < 001). Despite a significant bigger subfascial hematoma in the non-drained group (P < 0.05), in terms of pain, thigh swelling, total blood loss, number of transfusions needed, hip function and HTO no difference was recorded between the groups (P = 0.2-0.82).ConclusionTo omit CSD in primary THR results in simplified and more rapid wound management without any disadvantage at short and long term.

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