Are Wound Drains Superior To Non-drains After Total Hip Arthroplasty?

Objective:The purpose of this meta-analysis was to assess the effects ofwound drainage on wound infection,wound hematoma,transfusion,deep venousthrombosis(DVT),total blood loss,hemoglobin drop and hospital stay in non-hipfracture patients treated with total hip arthroplasty(THA).Methods:All randomized controlled trials(RCTs) compared drainage withnon-drainage in non-hip fracture patients undergoing THA surgery wereconsidered for inclusion.Subgroups was determined based on the time ofremoval of the drainage (after24hours or48hours). Mantel-Haensel andinverse variance methods for meta-analysis (fixed-and random-effectsmodels)were used.Results:13studies recruited1376non-hip fracture patients wereincluded.Compared with wound drainage,the rate of transfusion was lower withnon-drainage (RRs=1.30;95%CI1.05-1.60;P=0.02).The occurrence of woundinfection(RRs=1.00;95%CI=0.98-1.03;P=0.90)，wound ematoma(SMDs=-0.43;95%CI-1.15-0.29;P=0.24)deep venous thrombosis (RRs=1.68;95%CI0.41-6.94; P=0.47)total blood loss(MDs=-10.38;95%CI-136.34-115.59;p=0.87)hemoglobin drop(MDs=-0.19;95%CI-0.41-0.04; P=0.10) and hospital stay(MDs=0.06;95%CI-0.88-1.01;P=0.90) was uncertain.Conclusions:We concluded that the rate of transfusion can be reduced bypreventing the use of drains in non-hip fracture patients treated with THA,otheroutcomes measures of patients treated with drains who undergoing THA did notshow significant difference when compared with non-drainage.Drains could beomitted in THA in non-hip fracture patients.