EFFICACY OF CLOSED WOUND DRAINAGE AFTER TOTAL JOINT ARTHROPLASTY - A PROSPECTIVE RANDOMIZED STUDY

The efficacy of closed suction drains following joint arthroplasty ope rations was prospectively evaluated in a randomized manner. All 88 pat ients allotted to primary knee or hip arthroplasty operations during a 6-month period were included in the study. Drains were used in 32 of 58 patients following total knee arthroplasty and in 18 of 30 total hi p arthroplasties. No statistical difference was found in the hemoglobi n levels measured following surgery and in the number of patients requ iring blood transfusions between the two groups after total hip arthro plasty (P = .06). The power of the test to detect a difference of 2 g% in hemoglobin levels is 94%. Two patients from each group had a trans ient serous discharge for 3 to 4 days following surgery and none had w ound infections. Significantly more blood transfusions were needed in patients with drains following total knee arthroplasty compared with p atients without drains (0.7 unit per patient versus 0.2 unit per patie nt, P = .005) to maintain the same hemoglobin blood levels. Patients w ith no drains had significantly more transient sterile serous wound di scharge than patients with drains (38.4% vs 12.5%, P = .02). Superfici al wound infection necessitating antimicrobial medication developed in one patient with drains and in no patients in the other group. These results suggest that drains may not be needed following total hip arth roplasty. The more common serous wound discharge may be of some concer n when drains are not used following total knee arthroplasty.