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Comparison between two methods of drain clamping after total knee arthroplasty

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Abstract

Introduction

To study the clinical outcome of two methods of drain clamping after total knee arthroplasty and to determine the effect on blood loss and blood transfusion.

Patients and methods

A prospective study involving 73 patients, randomized into two groups. Group 1 included patients in whom the drain was clamped for 1 h postoperatively, after which it was released and kept open for 48 h. Group 2 included patients in whom the drain was clamped and released for 10 min every 2 h for 24 h. The drain was removed at 48 h in both groups. Patient’s demographic details, intraoperative and postoperative blood loss, and haemoglobin values on the preoperative and postoperative days (1, 4, 7, 14) were recorded.

Results

The mean postoperative drainage in group 1 was 520.65±170 ml, which was significantly higher than that of group 2, 367.62±141.1 ml (p<0.05, Student’s t-test). The drain charting shows 65% of drainage volume occurs in the first 8 h in both groups. The study suggests a reduction in the incidence of blood transfusion in the 2-hourly groups, although it was not statistically significant. There was a difference in the haemoglobin drop between both groups, but statistically the p value was marginally above 0.05 (p=0.086) and hence not significant.

Conclusion

The method of 2-hourly clamping of drain and release for 10 min significantly reduces postoperative blood loss, without any added increase of complication, after total knee arthroplasty.

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References

  1. Adalberth G, Bystrom S, Kolstad K, Mallminn H, Milbrink J (1998) Postoperative drainage of knee arthroplasty is not necessary: a randomized study. Acta Orthop Scand 69:475–478

    CAS  PubMed  Google Scholar 

  2. Akizuki S, Yasukawa Y, Takizawa T (1997) A new method of haemostasis for cement less total knee arthroplasty. Bull Hosp Jt Dis 56:222–224

    CAS  PubMed  Google Scholar 

  3. Beer KJ, Lombardi AV Jr, Mallory TH (1991) The efficacy of suction drains after routine total joint arthroplasty. J Bone Joint Surg Am 73:584–587

    CAS  PubMed  Google Scholar 

  4. Brueggemann PM, Tucker JK, Wilson P (1999) Intermittent clamping of suction drains in total hip replacement reduces postoperative blood loss: a randomized controlled trial. J Arthroplasty 14: 470–472

    CAS  PubMed  Google Scholar 

  5. Cobb JP (1990) Why use drains? J Bone Joint Surg Br 72:993–995

    CAS  PubMed  Google Scholar 

  6. Crevoisier XM, Reber P, Noesberger B (1998) Is suction drainage necessary after total joint arthroplasty? Arch Orthop Trauma Surg 117:124

    Google Scholar 

  7. Cushner FD, Friedman RJ (1991) Blood loss in total knee arthroplasty. Clin Orthop 269:98–101

    PubMed  Google Scholar 

  8. Drinkwater CJ, Neil MJ (1995) Optimal timing of wound drain removal following total joint arthroplasty. J Arthroplasty 10:185–189

    CAS  PubMed  Google Scholar 

  9. Holt BT, Parks NL, EngH GA, Lawrence JM (1997) Comparison of closed-suction drainage and no drainage after primary total knee arthroplasty. Orthopaedics 20:1121–1124

    CAS  Google Scholar 

  10. Kim Y-H, Cho S-H, Kim RS (1998) Drainage versus non drainage in simultaneous bilateral total knee arthroplasties. Clin Orthop 347:188–193

    PubMed  Google Scholar 

  11. Levy M (1984) Intraperitoneal drainage. Am J Surg 147:309–314

    CAS  PubMed  Google Scholar 

  12. Mengal B, Aebi J, Rodriquez A, Lemaire RA (2001) Prospective randomized study of wound drainage versus non-drainage in primary total hip or knee arthroplasty [French-English abstract]. Rev Chirurgic Orthop Reparatrice Appar Mot 87: 29–39

    CAS  Google Scholar 

  13. Ovadia D, Luger E, Bickels J et al (1997) Efficacy of closed wound drainage after total joint arthroplasty: a prospective randomized study. J Arthroplasty 12:317–321

    CAS  PubMed  Google Scholar 

  14. Reilly TJ, Gradisar IA Jr, Pakan W, Reilly M (1986) The use of postoperative suction drainage in total knee arthroplasty. Clin Orthop 208:238–242

    PubMed  Google Scholar 

  15. Ritter MA, Keating EM, Faris PM (1994) Closed wound drainage in total hip or total knee replacement. A prospective, randomized study. J Bone Joint Surg Am 76:35–38

    CAS  PubMed  Google Scholar 

  16. Ryu J, Sakamoto A, Honda T, Saito S (1997) The postoperative drain-clamping method for haemostasis in total knee arthroplasty: reducing postoperative bleeding in total knee arthroplasty. Bull Hosp Jt Dis 56:251–254

    CAS  PubMed  Google Scholar 

  17. Sakihara H, Fukubayashi T, Okuwaki T (1988) A method to control postoperative bleeding after total knee replacement [in Japanese]. Orthop Surg Traumatol 31:543

    Google Scholar 

  18. Sedna H, Nomurak, Hirano M et al (1990) Total blood loss in total knee arthroplasty: a comparison of drains clamped and non drain-clamped operation [in Japanese; English abstract]. Seikeigekatosaigaigeka 37:1739

    Google Scholar 

  19. Yamada K, Imaizumi T, Uemura M, Takada N, Kim Y (2001) Comparison between 1-hour and 24-hour drain clamping using diluted epinephrine solution after total knee arthroplasty. J Arthroplasty 16:458–462

    CAS  PubMed  Google Scholar 

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Correspondence to Narayana Prasad.

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Prasad, N., Padmanabhan, V. & Mullaji, A. Comparison between two methods of drain clamping after total knee arthroplasty. Arch Orthop Trauma Surg 125, 381–384 (2005). https://doi.org/10.1007/s00402-005-0813-7

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  • DOI: https://doi.org/10.1007/s00402-005-0813-7

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