Abstract
We aim to determine whether the presence of a drain increases the actual blood transfusion rates in patients undergoing primary total knee arthroplasty (TKA). A retrospective review was performed on two consecutive groups of patients who underwent primary TKA: group 1 including 100 patients who underwent TKA and had one deep closed suction drain; group 2 including 100 patients who underwent TKA and had no drain. Blood transfusions were given post-operatively on the basis of clinical need without a pre-determined haemoglobin trigger factor. Group 1 drained a mean of 692 ml (range 150–1500) of blood in 48 h. The mean fall in haemoglobin at 48 h post-operatively was 3.26 g/dl in group 1 and 3.33 g/dl in group 2. Nine patients in group 1 and seven patients in group 2 required a blood transfusion; this was not statistically significant (P=0.79). Transfusion of primary TKA patients on the basis of clinical need can result in post-operative transfusion rates of 8%. The presence of a drain does not increase the transfusion rates of patients undergoing primary TKA.
Résumé
Le but de cette étude est de déterminer si la mise en place d’un drain entraîne une augmentation du taux de transfusion chez les patients qui ont bénéficié d’une prothèse totale du genou. Une étude rétrospective a été réalisée à partir d’un groupe de patients ayant bénéficié d’une prothèse totale du genou de première intention. Dans le premier groupe 5 patients ont bénéficié d’une prothèse totale avec un drainage, dans le deuxième groupe, 100 patients ont bénéficié de la même prothèse sans drain. Dans le premier groupe le drainage a permis de récolter 692 ml de sang (150 à 1.500) en 48 heures. Le taux moyen d’hémoglobine post-opératoire à 48 heures était de 3.26 g/dl dans le groupe 1 et de 3.33 g/dl dans le groupe 2. 9 patients du groupe 1 et 7 patients du groupe 2 ont nécessité une transfusion. La différence n’est pas significative. Le taux de patients nécessitant une transfusion post-opératoire est de 8%, l’indication étant posée sur l’état clinique du patient, la présence d’un drain n’augmente pas le taux de transfusion après une prothèse totale du genou de première intention.
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Sundaram, R.O., Parkinson, R.W. Closed suction drains do not increase the blood transfusion rates in patients undergoing total knee arthroplasty. International Orthopaedics (SICO 31, 613–616 (2007). https://doi.org/10.1007/s00264-006-0232-6
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DOI: https://doi.org/10.1007/s00264-006-0232-6