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.	郝鵬, 裴福興. 人工髖關節置換術的進展. 現代預防醫學, 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.	岑光榮, 黃培祥, 陳志沖, 等. 抗凝藥物對全髖關節置換術后隱形失血的影響. 中醫正骨, 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.	馮潔, 周振東, 耿立成, 等. C-D手術中失血量及相關因素研究. 中國矯形外科雜志, 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.	叢宇, 趙建寧. 人工關節置換術后失血的相關研究. 醫學研究生學報, 2010, 23(12) :1332-1336.
11.	高福強, 李子劍, 張克, 等. 人工關節置換術后隱性失血計算方法的初步探析. 中華外科雜志, 2011, 49(12) :1144-1147.
12.	叢宇, 趙建寧, 包倪榮, 等. 隱性失血對全髖關節置換術后功能恢復影響的臨床觀察. 中國骨傷, 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. 全髖關節及全膝關節置換術后隱性失血的臨床影響. 中華骨科雜志, 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.	陳建常, 歐勇. 非骨水泥型人工全髖關節置換術后兩種引流方式的比較. 中國矯形外科雜志, 2013, 21(14) :1397-1401.
19.	陳良龍, 王萬春, 毛新展, 等. 老齡患者全髖膝關節置換術失血量的及時評估和處理. 中南大學學報(醫學版), 2007, 32(2) :316-319.
20.	程文俊, 徐海軍, 肖志宏, 等. 利伐沙班抗凝狀態下術后自體引流血回輸對初次全髖關節置換術后隱性失血和肢體腫脹的影響. 南方醫科大學學報, 2014, 34(3) :438-440.
21.	高福強, 李子劍, 張克, 等. 初次全膝關節置換術后隱性失血的影響因素研究. 中華外科雜志, 2011, 49(5) :419-423.
22.	李征, 曹光磊, 沈惠良. 全膝關節置換術的隱性失血及影響因素分析. 中華創傷雜志, 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.	李軍, 周云, 荊玨華, 等. 兩種抗凝藥物對人工全髖關節置換術隱性失血的影響比較. 中國修復重建外科雜志, 2013, 27(4) :432-435.
25.	劉旭東, 張先龍, 曾炳芳, 等. 全髖關節置換術后的隱性失血分析. 中國矯形外科雜志, 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.	中華醫學會骨科學分會. 中國骨科大手術靜脈血栓栓塞癥預防指南. 中華骨科雜志, 2009, 29(6) :602-604.
31.	楊景武, 史曉林. 人工全髖關節置換術后下肢深靜脈血栓形成原因的實驗觀察. 中國臨床康復, 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.	劉義輝, 劉雯爽. 全髖關節置換術后失血綜合管理的探討. 中國中醫骨傷科雜志, 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.	郭煒, 李榮文, 徐光輝, 等. 定制型人工髖關節置換治療股骨近端瘤性病變. 中國修復重建外科雜志, 2006, 20(10) :989-991.

1. 郝鵬, 裴福興. 人工髖關節置換術的進展. 現代預防醫學, 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. 岑光榮, 黃培祥, 陳志沖, 等. 抗凝藥物對全髖關節置換術后隱形失血的影響. 中醫正骨, 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. 馮潔, 周振東, 耿立成, 等. C-D手術中失血量及相關因素研究. 中國矯形外科雜志, 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. 叢宇, 趙建寧. 人工關節置換術后失血的相關研究. 醫學研究生學報, 2010, 23(12) :1332-1336.
11. 高福強, 李子劍, 張克, 等. 人工關節置換術后隱性失血計算方法的初步探析. 中華外科雜志, 2011, 49(12) :1144-1147.
12. 叢宇, 趙建寧, 包倪榮, 等. 隱性失血對全髖關節置換術后功能恢復影響的臨床觀察. 中國骨傷, 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. 全髖關節及全膝關節置換術后隱性失血的臨床影響. 中華骨科雜志, 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. 陳建常, 歐勇. 非骨水泥型人工全髖關節置換術后兩種引流方式的比較. 中國矯形外科雜志, 2013, 21(14) :1397-1401.
19. 陳良龍, 王萬春, 毛新展, 等. 老齡患者全髖膝關節置換術失血量的及時評估和處理. 中南大學學報(醫學版), 2007, 32(2) :316-319.
20. 程文俊, 徐海軍, 肖志宏, 等. 利伐沙班抗凝狀態下術后自體引流血回輸對初次全髖關節置換術后隱性失血和肢體腫脹的影響. 南方醫科大學學報, 2014, 34(3) :438-440.
21. 高福強, 李子劍, 張克, 等. 初次全膝關節置換術后隱性失血的影響因素研究. 中華外科雜志, 2011, 49(5) :419-423.
22. 李征, 曹光磊, 沈惠良. 全膝關節置換術的隱性失血及影響因素分析. 中華創傷雜志, 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. 李軍, 周云, 荊玨華, 等. 兩種抗凝藥物對人工全髖關節置換術隱性失血的影響比較. 中國修復重建外科雜志, 2013, 27(4) :432-435.
25. 劉旭東, 張先龍, 曾炳芳, 等. 全髖關節置換術后的隱性失血分析. 中國矯形外科雜志, 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. 中華醫學會骨科學分會. 中國骨科大手術靜脈血栓栓塞癥預防指南. 中華骨科雜志, 2009, 29(6) :602-604.
31. 楊景武, 史曉林. 人工全髖關節置換術后下肢深靜脈血栓形成原因的實驗觀察. 中國臨床康復, 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. 劉義輝, 劉雯爽. 全髖關節置換術后失血綜合管理的探討. 中國中醫骨傷科雜志, 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. 郭煒, 李榮文, 徐光輝, 等. 定制型人工髖關節置換治療股骨近端瘤性病變. 中國修復重建外科雜志, 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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