Therapeutics and Clinical Risk Management (Jul 2018)

Effect of a 12-hour natural drainage technique on decreasing blood loss after total knee arthroplasty: a case-control study

  • Shi M,
  • Zhang J,
  • Zhang Y,
  • Yan S,
  • Wu H

Journal volume & issue
Vol. Volume 14
pp. 1169 – 1174

Abstract

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Mingmin Shi,1 Jinjie Zhang,2 Yujie Zhang,1 Shigui Yan,1 Haobo Wu1 1Department of Orthopaedic Surgery, Second Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou 310009, People’s Republic of China; 2Department of Orthopedics, First Affiliated Hospital of Zhejiang Chinese Medical University, Hangzhou 310006, People’s Republic of China Background: Different methods of drainage have been used in patients with osteoarthritis after total knee arthroplasty (TKA), but the ideal strategy is controversial. This retrospective case-control study reported a technique of 12-hour natural drainage and aimed to confirm its efficacy and safety in the treatment for blood loss following TKA. Methods: There were 231 patients divided into three groups who underwent TKA from January 2014 to July 2017: 76 patients underwent 12-hour natural drainage in Group A, 80 patients underwent 4-hour clamping drainage in Group B, and 75 patients underwent continuous drainage in Group C. All perioperative clinical data were reviewed for statistical analysis. Results: The drainage volume and total blood loss after TKA were significantly lower in Group A than that in the other two groups (P<0.05), and serum level of hemoglobin was significantly higher in Group A than that in the other two groups (P<0.05). The maximum of active motion of the knee was greater in Group C at 2 days (P<0.05). Significantly more patients in Group C required blood transfusions (P<0.05). No difference was found in the complication rate among the three groups. Conclusion: The 12-hour natural drainage is an effective technique for reducing blood loss for patients following TKA. Compared with temporary clamping drainage and continuous negative pressure drainage, 12-hour natural drainage decreases blood loss, reduces post-operative transfusion requirements, and does not increase the risk of complications. Therefore, this technique of 12-hour natural drainage is recommended to be used in patients after TKA. Keywords: natural drainage technique, blood loss, total knee arthroplasty, case-control study

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