HEMOSTASIS EFFECT OF COMPRESSION DRESSING THERAPY AFTER TOTAL HIP ARTHROPLASTY_Chinese Journal of Reparative and Reconstructive Surgery

Authors：

TANMeiyun , WUTianhao , GUOJiang , ZHANGCaidong , FANZhongwei ,  GUOXing

Department of Bone and Joint Surgery, the Affiliated Hospital of Southwest Medical University, Luzhou Sichuan, 646000, P. R. China;

Corresponding author：

GUOXing, Email: gx412@126.com

Keywords：

Total hip arthroplasty; Compression dressing; Postoperative bleeding

DOI：

10.7507/1002-1892.20160084

Video：

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Objective To investigate the hemostasis effect of compression dressing therapy after total hip arthroplasty (THA). Method Thirty-four patients undergoing unilateral THA between December 2014 and March 2015 were randomly divided into observation group (compression dressing group, n=17) and control group (ordinary dressing group, n=17) . There was no significant difference in gender, age, height, weight, lesion hips, pathogeny, disease duration, and preoperative hemoglobin between 2 groups (P>0.05) . The total blood loss theoretical value, the postoperative drainage volume, the visible blood loss, the hidden blood loss, the total blood transfusion volume, the number of patients receiving blood transfusion, and the related complications were compared between 2 groups. Results No significant difference was found in operation time and hospitalization time between 2 groups (t=0.337, P=0.738; t=0.140, P=0.889) . The incisions healed by first intention in all patients. Six cases had incision subcutaneous hematoma in the control group, no incision subcutaneous hematoma occurred in the observation group (χ²=7.286, P=0.018) . No postoperative complications of wound superficial infection and venous thrombosis occurred in 2 groups. After operation, blood transfusion was given in 1 case of observation group and 7 cases of control group, showing significant difference (χ²=5.885, P=0.039) , and the total blood transfusion volume was 600 mL and 3 200 mL, respectively. There was no significant difference in preoperative blood volume and intraoperative blood loss between 2 groups (P>0.05) , but the total blood loss theoretical value, the postoperative drainage volume, the visible blood loss, and the hidden blood loss in observation group were significantly less than those in control group (P<0.05) . Conclusions The compression dressing should be performed after THA because it can effectively reduce postoperative blood loss and the incidence of wound hematoma.

Citation： TANMeiyun, WUTianhao, GUOJiang, ZHANGCaidong, FANZhongwei, GUOXing. HEMOSTASIS EFFECT OF COMPRESSION DRESSING THERAPY AFTER TOTAL HIP ARTHROPLASTY. Chinese Journal of Reparative and Reconstructive Surgery, 2016, 30(4): 416-420. doi: 10.7507/1002-1892.20160084 Copy

1.	郝鹏, 裴福兴. 人工髋关节置换术的进展. 现代预防医学, 2007, 34(3) :537-539.
2.	Sehat KR, Evans RL, Newman JH. Hidden blood loss following hip and knee arthroplasty. Correct management of blood loss should take hidden loss into account. J Bone Joint Surg (Br), 2004, 86(4) :561-565.
3.	Hoefnagels EM, Obradov M, Reijnierse M, et al. Sonography after total hip replacement:Reproducibility and normal values in 47 clinically uncomplicated cases. Acta Orthop, 2007, 78(1) :81-85.
4.	岑光荣, 黄培祥, 陈志冲, 等. 抗凝药物对全髋关节置换术后隐形失血的影响. 中医正骨, 2013, 25(11) :823-825.
5.	Tsuda K, Kawasaki T, Nakamura N, et al. Natural course of asymptomatic deep venous thrombosis in hip surgery without pharmacologic thromboprophylaxis in an Asian population. Clin Orthop Relat Res, 2011, 468(9) :2430-2436.
6.	Nadler SB, Hidalgo JU, Bloch T. Prediction of blood volume in normal human adults. Surgery, 1962, 51(2) :224-232.
7.	冯洁, 周振东, 耿立成, 等. C-D手术中失血量及相关因素研究. 中国矫形外科杂志, 2002, 9(1) :88-89.
8.	Gross JB. Estimating allowable blood loss:corrected for dilution. Anesthesiology, 1983, 58(3) :277-280.
9.	Liu X, Zhang X, Chen Y, et al. Hidden blood loss after total hip arthroplasty. J Arthroplasty, 2011, 26(7) :1100-1105.
10.	丛宇, 赵建宁. 人工关节置换术后失血的相关研究. 医学研究生学报, 2010, 23(12) :1332-1336.
11.	高福强, 李子剑, 张克, 等. 人工关节置换术后隐性失血计算方法的初步探析. 中华外科杂志, 2011, 49(12) :1144-1147.
12.	丛宇, 赵建宁, 包倪荣, 等. 隐性失血对全髋关节置换术后功能恢复影响的临床观察. 中国骨伤, 2011, 24(6) :466-468.
13.	Sehat KR, Evans RL, Newman JH. How much blood is really lost in total knee anhroplasty? Correct blood loss management should take hidden loss into count. Knee, 2000, 7(3) :151-155.
14.	Erskine JG, Fraser C, Simpson R, et al. Blood loss with knee joint replacement. J R Coll Surg Edinb, 1981, 26(5) :295-297.
15.	McManus KT, Velchik MG, Alavi A, et al. Non-invasive assessment of postoperative bleeding in TKA patients with Tc-99m RNCs. J Nuclear Med, 1987, 28:565-567.
16.	覃健, 余存泰, 徐中和, 等. 全髋关节及全膝关节置换术后隐性失血的临床影响. 中华骨科杂志, 2006, 26(5) :323-326.
17.	Pattison E, Protheroe K, Pringle RM, et al. Reduction in haemoglobin after knee joint surgery. Ann Rheum Dis, 1973, 32(6) :582-584.
18.	陈建常, 欧勇. 非骨水泥型人工全髋关节置换术后两种引流方式的比较. 中国矫形外科杂志, 2013, 21(14) :1397-1401.
19.	陈良龙, 王万春, 毛新展, 等. 老龄患者全髋膝关节置换术失血量的及时评估和处理. 中南大学学报(医学版), 2007, 32(2) :316-319.
20.	程文俊, 徐海军, 肖志宏, 等. 利伐沙班抗凝状态下术后自体引流血回输对初次全髋关节置换术后隐性失血和肢体肿胀的影响. 南方医科大学学报, 2014, 34(3) :438-440.
21.	高福强, 李子剑, 张克, 等. 初次全膝关节置换术后隐性失血的影响因素研究. 中华外科杂志, 2011, 49(5) :419-423.
22.	李征, 曹光磊, 沈惠良. 全膝关节置换术的隐性失血及影响因素分析. 中华创伤杂志, 2010, 26(9) :831-834.
23.	Prasad N, Padmanabhan V, Mullaji A. Blood loss in total knee arthroplasty:an analysis of risk factors. Int Orthop, 2007, 31(1) :39-44.
24.	李军, 周云, 荆珏华, 等. 两种抗凝药物对人工全髋关节置换术隐性失血的影响比较. 中国修复重建外科杂志, 2013, 27(4) :432-435.
25.	刘旭东, 张先龙, 曾炳芳, 等. 全髋关节置换术后的隐性失血分析. 中国矫形外科杂志, 2011, 19(12) :995-997.
26.	Bagsby DT, Hur J. Effect of intra-articular injection of tranexamic acid on postoperative hemoglobin in total hip arthroplasty. Orthopedics, 2014, 37(6) :e557-562.
27.	Wind TC, Barfield WR, Moskal JT. The effect of tranexamic acid on transfusion rate in primary total hip arthroplasty. J Arthroplasty, 2014, 29(2) :387-389.
28.	Sukeik M, Alshryda S, Haddad FS, et al. Systematic review and meta-analysis of the use of tranexamic acid in total hip replacement. J Bone Joint Surg (Br), 2011, 93(1) :39-46.
29.	Parker MJ, Roberts CP, Hay D. Closed Suction Drainage for Hip and Knee Arthroplasty. J Bone Joint Surg (Am), 2004, 86-A(6) :1146-1152.
30.	中华医学会骨科学分会. 中国骨科大手术静脉血栓栓塞症预防指南. 中华骨科杂志, 2009, 29(6) :602-604.
31.	杨景武, 史晓林. 人工全髋关节置换术后下肢深静脉血栓形成原因的实验观察. 中国临床康复, 2005, 9(42) :164-166.
32.	Shimoyama Y, Sawai T, Tatsumi S, et al. Perioperative risk factors for deep vein thrombosis after total hip arthroplasty or total knee arthroplasty. J Clin Anesth, 2012, 24(7) :531-536.
33.	刘义辉, 刘雯爽. 全髋关节置换术后失血综合管理的探讨. 中国中医骨伤科杂志, 2012, 20(12) :37-38.
34.	Charalambides C, Beer M, Melhuish J, et al. Bandaging technique after knee replacement. Acta Orthop, 2005, 76(1) :89-94.
35.	Johansson T, Engquist M, Pettersson LG, et al. Blood loss after total hip replacement:a prospective randomized study between wound compression and drainage. J Arthroplasty, 2005, 20(8) :967-971.
36.	Liu K, Chen LE, Seaber AV, et al. Intermittent pneumatic compression of legs increases microcirculation in distant skeletal muscle. J Orthop Res, 1999, 17(1) :88-95.
37.	Leegwater NC, Willems JH, Brohet R, et al. Cryocompression therapy after elective arthroplasty of the hip. Hip Int, 2012, 22(5) :527-533.
38.	Fujisawa M, Naito M, Asayama I, et al. Effect of calf-thigh intermittent pneumatic compression device after total hip arthroplasty:comparative analysis with plantar compression on the effectiveness of reducing thrombogenesis and leg swelling. J Orthop Sci, 2003, 8(6) :807-811.
39.	郭炜, 李荣文, 徐光辉, 等. 定制型人工髋关节置换治疗股骨近端瘤性病变. 中国修复重建外科杂志, 2006, 20(10) :989-991.

1. 郝鹏, 裴福兴. 人工髋关节置换术的进展. 现代预防医学, 2007, 34(3) :537-539.
2. Sehat KR, Evans RL, Newman JH. Hidden blood loss following hip and knee arthroplasty. Correct management of blood loss should take hidden loss into account. J Bone Joint Surg (Br), 2004, 86(4) :561-565.
3. Hoefnagels EM, Obradov M, Reijnierse M, et al. Sonography after total hip replacement:Reproducibility and normal values in 47 clinically uncomplicated cases. Acta Orthop, 2007, 78(1) :81-85.
4. 岑光荣, 黄培祥, 陈志冲, 等. 抗凝药物对全髋关节置换术后隐形失血的影响. 中医正骨, 2013, 25(11) :823-825.
5. Tsuda K, Kawasaki T, Nakamura N, et al. Natural course of asymptomatic deep venous thrombosis in hip surgery without pharmacologic thromboprophylaxis in an Asian population. Clin Orthop Relat Res, 2011, 468(9) :2430-2436.
6. Nadler SB, Hidalgo JU, Bloch T. Prediction of blood volume in normal human adults. Surgery, 1962, 51(2) :224-232.
7. 冯洁, 周振东, 耿立成, 等. C-D手术中失血量及相关因素研究. 中国矫形外科杂志, 2002, 9(1) :88-89.
8. Gross JB. Estimating allowable blood loss:corrected for dilution. Anesthesiology, 1983, 58(3) :277-280.
9. Liu X, Zhang X, Chen Y, et al. Hidden blood loss after total hip arthroplasty. J Arthroplasty, 2011, 26(7) :1100-1105.
10. 丛宇, 赵建宁. 人工关节置换术后失血的相关研究. 医学研究生学报, 2010, 23(12) :1332-1336.
11. 高福强, 李子剑, 张克, 等. 人工关节置换术后隐性失血计算方法的初步探析. 中华外科杂志, 2011, 49(12) :1144-1147.
12. 丛宇, 赵建宁, 包倪荣, 等. 隐性失血对全髋关节置换术后功能恢复影响的临床观察. 中国骨伤, 2011, 24(6) :466-468.
13. Sehat KR, Evans RL, Newman JH. How much blood is really lost in total knee anhroplasty? Correct blood loss management should take hidden loss into count. Knee, 2000, 7(3) :151-155.
14. Erskine JG, Fraser C, Simpson R, et al. Blood loss with knee joint replacement. J R Coll Surg Edinb, 1981, 26(5) :295-297.
15. McManus KT, Velchik MG, Alavi A, et al. Non-invasive assessment of postoperative bleeding in TKA patients with Tc-99m RNCs. J Nuclear Med, 1987, 28:565-567.
16. 覃健, 余存泰, 徐中和, 等. 全髋关节及全膝关节置换术后隐性失血的临床影响. 中华骨科杂志, 2006, 26(5) :323-326.
17. Pattison E, Protheroe K, Pringle RM, et al. Reduction in haemoglobin after knee joint surgery. Ann Rheum Dis, 1973, 32(6) :582-584.
18. 陈建常, 欧勇. 非骨水泥型人工全髋关节置换术后两种引流方式的比较. 中国矫形外科杂志, 2013, 21(14) :1397-1401.
19. 陈良龙, 王万春, 毛新展, 等. 老龄患者全髋膝关节置换术失血量的及时评估和处理. 中南大学学报(医学版), 2007, 32(2) :316-319.
20. 程文俊, 徐海军, 肖志宏, 等. 利伐沙班抗凝状态下术后自体引流血回输对初次全髋关节置换术后隐性失血和肢体肿胀的影响. 南方医科大学学报, 2014, 34(3) :438-440.
21. 高福强, 李子剑, 张克, 等. 初次全膝关节置换术后隐性失血的影响因素研究. 中华外科杂志, 2011, 49(5) :419-423.
22. 李征, 曹光磊, 沈惠良. 全膝关节置换术的隐性失血及影响因素分析. 中华创伤杂志, 2010, 26(9) :831-834.
23. Prasad N, Padmanabhan V, Mullaji A. Blood loss in total knee arthroplasty:an analysis of risk factors. Int Orthop, 2007, 31(1) :39-44.
24. 李军, 周云, 荆珏华, 等. 两种抗凝药物对人工全髋关节置换术隐性失血的影响比较. 中国修复重建外科杂志, 2013, 27(4) :432-435.
25. 刘旭东, 张先龙, 曾炳芳, 等. 全髋关节置换术后的隐性失血分析. 中国矫形外科杂志, 2011, 19(12) :995-997.
26. Bagsby DT, Hur J. Effect of intra-articular injection of tranexamic acid on postoperative hemoglobin in total hip arthroplasty. Orthopedics, 2014, 37(6) :e557-562.
27. Wind TC, Barfield WR, Moskal JT. The effect of tranexamic acid on transfusion rate in primary total hip arthroplasty. J Arthroplasty, 2014, 29(2) :387-389.
28. Sukeik M, Alshryda S, Haddad FS, et al. Systematic review and meta-analysis of the use of tranexamic acid in total hip replacement. J Bone Joint Surg (Br), 2011, 93(1) :39-46.
29. Parker MJ, Roberts CP, Hay D. Closed Suction Drainage for Hip and Knee Arthroplasty. J Bone Joint Surg (Am), 2004, 86-A(6) :1146-1152.
30. 中华医学会骨科学分会. 中国骨科大手术静脉血栓栓塞症预防指南. 中华骨科杂志, 2009, 29(6) :602-604.
31. 杨景武, 史晓林. 人工全髋关节置换术后下肢深静脉血栓形成原因的实验观察. 中国临床康复, 2005, 9(42) :164-166.
32. Shimoyama Y, Sawai T, Tatsumi S, et al. Perioperative risk factors for deep vein thrombosis after total hip arthroplasty or total knee arthroplasty. J Clin Anesth, 2012, 24(7) :531-536.
33. 刘义辉, 刘雯爽. 全髋关节置换术后失血综合管理的探讨. 中国中医骨伤科杂志, 2012, 20(12) :37-38.
34. Charalambides C, Beer M, Melhuish J, et al. Bandaging technique after knee replacement. Acta Orthop, 2005, 76(1) :89-94.
35. Johansson T, Engquist M, Pettersson LG, et al. Blood loss after total hip replacement:a prospective randomized study between wound compression and drainage. J Arthroplasty, 2005, 20(8) :967-971.
36. Liu K, Chen LE, Seaber AV, et al. Intermittent pneumatic compression of legs increases microcirculation in distant skeletal muscle. J Orthop Res, 1999, 17(1) :88-95.
37. Leegwater NC, Willems JH, Brohet R, et al. Cryocompression therapy after elective arthroplasty of the hip. Hip Int, 2012, 22(5) :527-533.
38. Fujisawa M, Naito M, Asayama I, et al. Effect of calf-thigh intermittent pneumatic compression device after total hip arthroplasty:comparative analysis with plantar compression on the effectiveness of reducing thrombogenesis and leg swelling. J Orthop Sci, 2003, 8(6) :807-811.
39. 郭炜, 李荣文, 徐光辉, 等. 定制型人工髋关节置换治疗股骨近端瘤性病变. 中国修复重建外科杂志, 2006, 20(10) :989-991.

Chinese Journal of Reparative and Reconstructive Surgery

HEMOSTASIS EFFECT OF COMPRESSION DRESSING THERAPY AFTER TOTAL HIP ARTHROPLASTY

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