Key result
Closed suction drains provided no benefit in primary uncomplicated hemiarthroplasty, whereas non-use drastically reduced anemia and the requirement for blood transfusion.
Why the study?
Does the use of closed suction drains improve outcomes or reduce complications in patients undergoing hemiarthroplasty for intracapsular fracture neck femur?
RCT
Randomized
No
Does the use of closed suction drains improve outcomes or reduce complications in patients undergoing hemiarthroplasty for intracapsular fracture neck femur?
The routine use of closed suction drains in uncomplicated hemiarthroplasty offers no benefit and may increase the risk of anemia and need for blood transfusion.
Introduction: Intracapsular fracture of neck femur usually present with severe swelling, difficulty in walking reduced length of affected limb. The most common Risk factors are old age, osteoporosis, taking excessive medications, alcohol, smoking and cancer. Diagnosis can be done by using X-rays, CT scan and MRI. Materials and Methods: It is a prospective study consists of all the patients admitted to JSS hospital with intracapsular fracture neck femur treated with unipolar or bipolar endoprosthesis. Results: The selected patients were randomized and divided into two groups, Group one (I) and Group two (II). Patients were suction tube is used are categorized into Group I and in those were suction tube is not used are categorized into Group II. These two groups were studied and observed for the following, fall in haemoglobin and PCV at 48 hours post-operatively. Complications are Persistent discharge, serous discharge from the wound for more than 10 days. Discussion: When the doctors are in doubt, then they need to insert a drain was countered by Halsted (1898). Now days in orthopedic cases, closed suction drains are being commonly used to decrease the complications. Blood accumulation in and around the tissue site will raise the tissue tension and thereby reduces tissue perfusion in and around the surgical wound site. Conclusion: We consider that there is ample evidence that closed suction drains is of no benefit in primary uncomplicated hemiarthroplasty. The advantage of the drains in orthopaedic surgeries should be debated as non use of drains drastically reduces anemia and requirement of blood transfusion after surgery. In a developing and under-developing countries, the cost increases because of the blood transfusion needs and costs of drain device which will outweigh any advantages of putting a drain.
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Chandru et al. (2018) conducted an RCT in Intracapsular fracture of neck femur. Closed suction drains vs. No suction drains was evaluated on Fall in haemoglobin and PCV at 48 hours post-operatively, and complications including persistent discharge. Closed suction drains provided no benefit in primary uncomplicated hemiarthroplasty, whereas non-use drastically reduced anemia and the requirement for blood transfusion.
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