Immediate Versus 2-Hour Delayed Deployment of Closed Suction Drain After Hip Hemiarthroplasty for Fracture Neck of Femur: Effect on Blood Loss, Haemoglobin Drop and Blood Transfusion Requirement – A Prospective Clinical Study

Background: Postoperative blood loss following hip hemiarthroplasty may contribute to haemoglobin decline and blood transfusion in elderly patients. Temporary closure of a suction drain may reduce early blood loss through a tamponade effect. Methods: This prospective observational study included 62 patients undergoing hemiarthroplasty for fracture neck of femur. Closed suction drains were opened immediately in 30 patients and after 2 hours in 32 patients. Drain output, serial haemoglobin and PCV levels, transfusion requirement, and hospital stay were evaluated. Results: Mean drain blood loss was significantly lower with delayed opening (145.0 vs 180.67 mL; p=0.02). Postoperative reductions in haemoglobin and PCV at 6, 24, and 48 hours were significantly greater in the immediate-opening group. Three patients (10%) in the immediate group required transfusion compared with none in the delayed group (p=0.06). Mean hospital stay was also shorter with delayed opening (8.12 vs 17.80 days; p=0.003). Conclusion: Two-hour delayed opening of closed suction drains following hip hemiarthroplasty was associated with reduced postoperative blood loss and smaller haemoglobin and PCV decline. It may represent a simple blood-conservation strategy in elderly patients undergoing hemiarthroplasty. Keywords: Fracture neck of femur; hemiarthroplasty; closed suction drain; drain clamping; blood loss; haemoglobin; blood transfusion