الفهرس 
Acknowledgment
Blood loss in primary THAOnly 14 pages are availabe for public view
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Abstract
This study aimed at providing clinical evidence through a RCT analyzing pros and cons of using CSDs after primary THA.
We compared two groups of patients, 50 patient in each, group A treated with CSDs and group B treated without CSDs regarding (reduction in Hb level 24hrs and 48hrs postoperatively – volume of visible blood loss – requirement for, and volume of blood transfusion – timing of surgical procedure - early SSI –wound condition and discharge – dressing reinforcement - wound ecchymosis – length of hospital stay postoperatively)
We found thatregarding;
• Hemoglobin level reduction; more significant reduction with use of CSDs.
• Risk for blood transfusion; significantly increased by use of CSDs.
• Incidence of early wound infection (SSI); no significant difference between two groups.
• Wound condition in form of (wound discharge, need for dressing reinforcement, wound ecchymosis) we found that there is significant difference between two groups. Treating patients with CSD improves wound condition with less discharge, less ecchymosis, less dressing reinforcements. But patients may feel some discomfort due to presence of drain, and even more discomfort during its removal.
• Lastly, regarding length of hospital stay, no significant difference between study groups.
Conclusion and recommendations
If we have to give a recommendation that is based on solid clinical evidence about use of drain in primary THA, we conclude that patients must be evaluated carefully preoperatively. If the patients’ clinical manifestation show anemia (Hb level at lower margin of normal range), we recommendthat drain should not be employed to decrease risk for blood loss and subsequent requirement for transfusion. If the general condition of the patient is just normal with high preoperative Hb level (high normal of 15g/dl or more), we recommend thatthe closed-suction drainage to be used for the favor of better wound condition (wound tension and discharge, need for dressing reinforcement, wound ecchymosis).