Compare the Frequency of Surgical Site Infections in Patients Undergoing Hip Surgery with Closed Suction Drain Placed At Surgical Site and Without Drain

Abstract

Introduction: Hip trauma is a debilitating event that leads to a major limitation in patient’s functional ability. The incidence of hip fractures increases with advancing age and are more common in old age individuals. Closed-suction drainage has been routinely used in total hip arthroplasty to prevent hematoma formation and surgical site infections (SSI). Objective: To compare the frequency of surgical site infections in patients undergoing hip surgery with closed suction drain placed at surgical site and without drain. Study Design: Randomized controlled trial. Place and Duration: The study was completed at department of Orthopedic Surgery Unit III, Bolan Medical College Hospital Quetta, Pakistan. The duration of study was from 1-April-2016 to 31-October-2017. Subjects and Methods: A total number of 176 patients who underwent hip arthroplasty were included in this study. Group A (n=88) patients underwent hip surgery with placement of drain and Group B patients underwent hip surgery without the placement of drains. Data analysis was carried out using SPSS v20.0. Chi-square test was applied to compare surgical site infections in drain group and without drain group. Effect modifiers were controlled by stratification. Post stratification Chi-square test was applied taking P-value <0.05 as significant. Results: The mean age of patients in this study was 42.26 (SD 9.86) years. There were 135 males (76.7%) patients in this study and 41 (23.3%) female patients. The mean duration of fracture was 39.41 (SD 7.74) days. There were 63 (35.8%) patients who presented with greater/lesser trochanteric fractures, 64 (36.4%) presented with sub-trochanteric fractures and 49 (27.8%) were presented with inter-trochanteric fractures. SSIs occurred in 7 patients in whom drain was inserted after surgery and in only 2 patients in whom drain was not inserted (p-value 0.08). There was no effect of confounder variables on the occurrence of SSIs. Conclusion: The risk of surgical site infections is same in patients undergoing hip surgery with closed suction drain placed at surgical site and without drain. Keywords: Hip fractures, Hip arthroplasty, Closed suction drains, Surgical site infections.