Umer Hafiz Muhammad, Iqbal Hafiz Javaid, Shah Nisarg, Vora Harshil, Mahmood Aatif, Board Tim
Trauma and Orthopedics, Stepping Hill Hospital, Manchester, GBR.
Trauma and Orthopedics, Countess of Chester Hospital, Chester, GBR.
Cureus. 2023 May 30;15(5):e39682. doi: 10.7759/cureus.39682. eCollection 2023 May.
Background There is a number of studies showing no significant benefit of using drains after primary hip arthroplasty. However, there is no consensus in the literature about the usage of drains in revision hip replacement. This study aims to assess the effect of drains in revision hip arthroplasty. Methods A retrospective analysis was performed of all consecutive revision hip replacement surgeries performed at our unit over a five-month period (November 2018 to March 2019). Case notes, laboratory investigations, and operative records were reviewed. The effects of drains on postoperative hemoglobin (Hb), transfusion rate, and complications were analyzed. Results Overall, 92 patients were analyzed who underwent revision hip replacement during the study period. There were 46 male and 46 female patients with a mean age of 72 years. Aseptic loosening was the most common indication for the revision (41 patients) followed by instability (21 patients), infection (11 patients), and periprosthetic fractures (eight patients). Seventy-two patients had no drains while suction drains were used in 20 patients. Both groups were similar regarding age, sex, and indications for revision surgery. There was a significantly higher drop in postoperative Hb in patients with drains than those without drains (33 g/L: 27 g/L, p=0.03). There were significantly more blood transfusions in patients with drains as compared to those without drains (15%: 8%, relative risk 1.8, and odds ratio 1.94). There was no difference in both groups with regard to returning to the theater. Discussion Use of suctions drains in revision hip surgery was associated with increased postoperative blood loss and increased requirement for postoperative blood transfusion. Revision hip surgery without routine usage of suction drains did not increase wound complications. Conclusion Revision surgery without routine usage of drains is safe and may decrease postoperative blood loss and the rate of transfusion.
多项研究表明，初次髋关节置换术后使用引流管并无显著益处。然而，关于翻修髋关节置换术中引流管的使用，文献中尚未达成共识。本研究旨在评估引流管在翻修髋关节置换术中的作用。方法：对本单位在五个月期间（2018年11月至2019年3月）进行的所有连续翻修髋关节置换手术进行回顾性分析。查阅病历、实验室检查和手术记录。分析引流管对术后血红蛋白（Hb）、输血率和并发症的影响。结果：总体而言，对研究期间接受翻修髋关节置换术的92例患者进行了分析。其中男性46例，女性46例，平均年龄72岁。无菌性松动是翻修的最常见原因（41例），其次是不稳定（21例）、感染（11例）和假体周围骨折（8例）。72例患者未使用引流管，20例患者使用了负压引流管。两组在年龄、性别和翻修手术指征方面相似。使用引流管的患者术后Hb下降幅度明显高于未使用引流管的患者（33 g/L: 27 g/L，p = 0.03）。与未使用引流管的患者相比，使用引流管的患者输血明显更多（15%: 8%，相对风险1.8，优势比1.94）。两组在返回手术室方面没有差异。讨论：翻修髋关节手术中使用负压引流管与术后失血量增加和术后输血需求增加有关。不常规使用负压引流管的翻修髋关节手术并未增加伤口并发症。结论：不常规使用引流管的翻修手术是安全的，可能会减少术后失血量和输血率。
