Postoperative course after total hip arthroplasty: wound drainage versus no drainage

This retrospective study of 364 patients with total hip replacements performed between 1985 and 1990 showed no benefit in the use of drains and found an increased rate of transfusion associated with the use of drains. The two study groups (171 patients with two closed-wound suction drains in the wound and 193 patients closed without drains) differed in the type but not in the rate of wound problems; the drained group had more drainage at the port site, whereas the undrained group had more ecchymosis and swelling. There was no significant difference between the groups in operative blood loss; however, the drained group did require transfusions significantly more often than the undrained group (98 of 171 [57.3%] as opposed to 83 of 193 [43%], respectively). Of the patients requiring transfusions, patients with wound drains required significantly more blood than those without drains (1.12 versus 0.62 transfusions per patient for men; 1.73 versus 1.03 transfusions per patient for women).