Hematomas and subcutaneous suture techniques in total hip replacement. An ultrasound study.

Thirty-five patients undergoing total hip replacement due to primary arthrosis were randomized into two groups. In one group each subcutaneous suture included a stitch in the fascia; in the other group the fascia was not included in the suture. Ultrasonography examination showed no significant difference in the number of subcutaneous hematomas in each group. Nine subcutaneous and nine deep hematomas were diagnosed by ultrasound in 15 patients. Three patients had a clinical diagnosis of hematoma and in only one of these did ultrasonography support the diagnosis. It appears that the clinical diagnosis of hematomas, even subcutaneous hematomas, is unreliable. Careful hemostasis is recommended.