Author/Editor		Strahovnik, Andrej
Title		Operativna rana neposredno po vstavitvi kolčne endoproteze: vpliv drenaže
Type		monografija
Place		Ljubljana
Publisher		Medicinska fakulteta
Publication year		2009
Volume		str. 60
Language		slo
Abstract		Background. The occurence of prolonged serous drainage is common after total hip arthroplasty. It has been shown to increase the risk of postoperative infection and delay hospital discharge. The aims of this study were to determine 1) whether the duration of closed suction drainage affects the occurence and duration of prolonged serous drainage and 2) if closed suction drains could be omitted according to the wound and/or thigh appearance and systemic complications after unilateral primary total hip arthroplasty. Methods. One hundred thirty-nine patients undergoing total hip arthroplasty were randomized into 3 groups: 42 patients received no drainage, 46 patients received drainage for 24 hours, and 51 patients received drainage for 48 hours. The occurence of serous drainage, thigh circumference and thigh pain were controlled. Results. No differences with respect to occurence and duration of prolonged serous drainage were found between the 3 groups with drains (P=0,225). Although no prolonged serous drainage occured, the swelling of the thigh was significantly greater (P<0,001) and the occurence of prolonged thigh pain was significantly higher (P=0,01) in the group without drainage. Conclusions. The duration of wound drainage does not have any influence on the incidence and duration of prolonged serous drainage. The absence of drainage was associated with increased swelling and pain of the thigh. The results of the current study suggest that closed suction drainage is safe and increasaes patient comfort after total hip arthroplasty.
Summary		Izhodišča. Podaljšana serozna sekrecija iz mesta drenov je po artroplastiki kolka pogost pojav. Serozna sekrecija povečuje možnost bakterijskega vnetja rane in podaljšuje hospitalizacijo. S študijo smo želeli ugotoviti: 1) ali trajanje zaprte aktivne drenaže vpliva na pojavnost in trajanje podaljšane serozne sekrecije in 2) ali bi lahko uporabo zaprte aktivne drenaže v kolčni artroplastiki ukinili brez sočasnih lokalnih in sistemskih neželenih učinkov. Metode. Ob vstavitvi kolčne endoproteze smo 139 bolnikov naključno porazdelili v 3 skupine: 42 bolnikov v skupino brez drenaže, 46 bolnikov v skupino s 24-urno drenažo in 51 bolnikov v skupino z 48-urno drenažo. Opazovali smo pojav serozne sekrecije, obseg stegna in bolečino v stegnu. Rezultati. Med skupinama z zaprto aktivno drenažo ni bilo razlik v pojavnosti in trajanju podaljšane serozne sekrecije (p=0,225). Čeprav v skupini brez drenaže serozne sekrecije ni bilo, pa je bila oteklina stegna v tej skupini pomembno večja (P<0,001), pomembno pogostejša je bila tudi bolečina v stegnu (P=0,01). Zaključki. Trajanje drenaže ne vpliva na pojav podaljšane serozne sekrecije. Odsotnost drenaže je bila povezana z večjo oteklino in pogostejšo bolečino v stegnu. Drenaža se je v naših pogojih izkazala za varno metodo, ki bolniku nudi več ugodja.
Descriptors		WOUNDS AND INJURIES DRAINAGE DRAINAGE POSTOPERATIVE COMPLICATIONS