CONSUMPTION OF BLOOD CONSERVES AFTER TOTAL HIP-REPLACEMENT DEPENDING ON DRAINAGE BY REDONS AND COMPRESSION BANDAGE

Problem: There is a difference in the use of redon drainage following hip arthroplasty worldwide. The aim of the study was to find the best version. Method: In a prospective randomized study including 158 patie nts with coxarthrosis we implanted cementless Alloclassic hip-endopros theses and registered consumption of blood, blood loss, hemoglobin lev el, subcutaneuos hematoma, swelling of the proximal thigh, bleeding an d exsudation of the wound in four groups supplied with three, two (sub cutaneously and subfascial) and one (subcutaneously or subfascial) dra inage with compression bandage and one group with two redons(subcutane ously and subfascial) without compression bandage. For prophylaxis of deep vein thrombosis we used low dose heparin. Result: We could demons trate, that the application of two redons one subcutaneously and one s ubfascial gave the best result. Compared to the conventional procedure with three redons we achieved a reduction of 47% of blood units, a si gnificant reduction of exsudation and bleeding out of the wound, subcu taneous hematomas and a reduced swelling of the proximal leg in additi on to better clinical conditions of the patients. The reason is a more accelerated stop of the bleeding out of the spongy bone. The applicat ion of one drain subcutaneously or subfascial showed no further reduct ion of blood loss, but an increase of wound exsudation and bleeding ou t the wound and an increase of subcutaneous hematomas. Sufficient exte rnal compression of the area of operation by a compression bandage is very important. Disadvantages as a result of changing the way of drain age have not been detected. Conclusion: The use of two Redons one subc utaneousley and one subfascial showed an obvious benefit without any c linical disatvantage compared to 3 redons or no drainage.