Comment on Zhou et al.: Do we really need closed-suction drainage in total hip arthroplasty? A meta-analysis

摘要

To the Editor:We read with great interest the article titled: "Do we really need closed-suction drainage in total hip arthroplasty? A meta-analysis", by Zhou et al. [1]. The authors conducted a meta-analysis to determine whether closed-suction drainage is safe and effective in promoting wound healing and reducing blood loss and other complications compared with no drainage in total hip arthroplasty (THA). The conclusions drawn seem questionable because of several apparent flaws in their study.Firstly, publication language was limited to English in the meta-analysis; therefore, the authors should consider the potential importance of language bias as a limitation, which was not mentioned. We suggest that publication bias be assessed by visual examination using a funnel plot and statistical tests (e.g. Egger's linear regression test or Begg's rank correlation test).Secondly, a study by Hill et al. [2], which was only a conference abstract, was included in their analysis to minimise bias against smaller studies that were not published in full. We do not agree with this inclusion. Obviously, Hill et al. published their prospective randomised controlled trial (RCT) again in 2005 [3]. To strengthen the credibility of Zhou et al.'s meta-analysis, information from Hill et al.'s abstract should be excluded.