CLOSED SUCTION DRAINAGE AFTER PRIMARY TOTAL KNEE REPLACEMENT: A PROSPECTIVE OBSERVATIONAL COHORT

Abstract

Background: There remains no clear guidance from the British Orthopaedic Association regarding the use of closed suction drains after primary total knee replacement (TKR). Previous studies suggest no benefit in their use and no significant difference between the type of drain used.

Aims: To assess whether allogenic transfusion requirements are altered by the use of closed suction drainage and to establish if drains reduce post-operative complications and length of stay in hospital.

Materials and Methods: 60 patients undergoing TKR in Eastbourne between December 2008 and June 2009 were evaluated pre- and post-operatively. The population was divided into those with no drain, a Redivac drain (fluid discarded) and a re-transfusion drain (fluid filtered and transfused into the patient).

Results: 23 patients had Redivac drains and 5 (22%) required an allogenic blood transfusion. 37 patients had no drain and 2 (5%) required allogenic blood. For the 14 re-transfusion drain patients none received allogenic blood. There was no significant difference in the length of stay across all 3 groups (p=> 0.25). There was a significantly higher incidence of wound ooze and cellulitis in patients with no drain (50%; p=< 0.01). This is in comparison to the other two groups where only 30% of patients with a Redivac drain and 7% of patients with a re-transfusion drain experienced these complications. There was no significant difference in the average haemoglobin drop between the 3 groups (p=> 0.1).

Conclusions: The results suggest a benefit in using drains to reduce the risk of post-operative wound ooze and cellulitis after TKR. Re-transfusion drains also appear to reduce the requirement for allogenic blood transfusion in the post-operative period.