BACKGROUND: The purpose of placing drainage tube after total hip arthroplasty is to drain the accumulated blood in the hip, so as to accelerate the recovery of patients. However, since tranexamic acid has been infused intravenously during the operation, and the effect of blood loss can be reduced exactly. It remains poorly understood that whether it is necessary to place a drainage tube routinely after the operation. OBJECTIVE: To investigate whether the drainage tube should be placed on the basis of hemostasis by intravenous drip of tranexamic acid in total hip arthroplasty. METHODS: From June 2017 to March 2019, 132 patients with primary unilateral total hip arthroplasty admitted to the Second Hospital of Shanxi Medical University were selected. During the operation, tranexamic acid was infused intravenously. Drainage tube was placed in 62 patients (drainage group) after total hip arthroplasty, and not placed in 70 patients (non-drainage group). The blood loss, blood transfusion rate, blood transfusion volume, hemoglobin value and complications were compared between the two groups. The average hospital stay of the two groups was compared. Harris score of hip joint was followed up after operation. The experiment was approved by the Ethics Committee of the Second Hospital of Shanxi Medical University. RESULTS AND CONCLUSION: (1) There was no significant difference in blood loss, blood transfusion rate, blood transfusion volume, and hemoglobin value between the two groups (P > 0. 05). (2) There was no significant difference in deep vein thrombosis of both lower limbs between the drainage group (four cases) and the non-drainage group (two cases) (P > 0. 05). (3) There were three cases of bleeding, three cases of infection, two cases of swelling and ecchymosis in the drainage group, and one case of bleeding and one case of swelling and ecchymosis in the non-drainage group. There were significant differences in incision complications between the two groups (P < 0. 05). (4) Average hospital stay was longer in the drainage group than in the non-drainage group (P < 0. 05). (5) There was no significant difference in Harris score of the hip joint between the two groups at 1, 3 and 6 months after operation (P > 0. 05). (6) The results showed that there was no need to place drainage tube after intravenous drip of tranexamic acid during total hip arthroplasty.

Objective:To investigate the clinical effect of vascular pressurisation and super reflux on free anterolateral thigh flap (ALTF).Methods:From January 2017 to September 2021, the Department of Hand and Foot Microsurgery, the Second Affiliated Hospital of Hainan Medical College had treated 31 cases of soft tissue defects of the limbs. The patients were 23 males and 8 females, aged 4-76 years old at 40 years old in average. All the patients received transfer of free ALTFs carrying 2 groups of blood vessels of the descending and oblique branches of lateral circumflex femoral artery (LCFA). The vascular pressurisation and super-reflux techniques were applied in wound repair. Soft tissue defect area 7 cm × 5 cm-22 cm × 10 cm. The sizes of flaps were 8 cm×6 cm-23 cm×11 cm. All the donor sites were sutured directly. Fifteen patients had inner flap pressurisation (or super-reflux) and the rest of 16 patients had external flap pressurisation (or super-reflux). After surgery, scheduled follow-ups were conducted through outpatient clinic, telephone and WeChat reviews or home visits to evaluate the efficacy of wound repair.Results:All the 31 flaps survived, except 2 flaps that had mild infection after surgery. The wounds of donor and recipient sites healed completely. The time of follow-up was 3-55 months. The skin of flaps achieved good texture, colour, lustre and appearance. TPD of the flaps ranged 7-12 mm.Conclusion:Vascular pressurisation and super reflux technique are stable and reliable in the clinical application of free ALTF to repair soft tissue defects of limbs.