No clear advantage to use of wound drains after unilateral total knee arthroplasty: a prospective randomized, controlled trial.

We conducted a prospective randomized, controlled trial in 100 patients to compare the postoperative use of wound drains with the use of no drains in patients who underwent unilateral primary total knee arthroplasty to determine differences in blood loss, range of motion, wound healing, complications (deep vein thrombosis, wound infection), and need for blood transfusions. The patients, who underwent surgery between February 2006 and February 2007, were randomly divided into 2 groups of 50 each: group A, treated without a drain, and group B, treated with a drain. The between-group difference in total blood loss was significant: 535 ± 295 mL in group A and 853 ± 331 mL in group B. Group A needed comparatively less blood transfused than group B did. Differences in wound infection, incidence of deep vein thrombosis, and range of motion were not statistically significant between groups. We found no clear advantage to the use of wound drains in unilateral total knee arthroplasty.

Comparison of no drain or with a drain after unilateral total knee arthroplasty: a prospective randomized controlled trial / 中华外科杂志

<p><b>OBJECTIVE</b>To prospectively compare of no drain or with drain after unilateral total knee arthroplasty (TKA).</p><p><b>METHODS</b>A randomized prospective study was conducted between February 2006 and February 2007. The study included 100 patients who were divided into 2 groups: group A (n = 50), which included patients without drain release, and group B (n = 50), which included patients who had a drain release. The true total blood loss was calculated depending on the height, body mass and pre-and post-operative Hct, and hidden blood loss was gotten by subtracting the visible blood loss from total loss. The recovery after surgery, the correlative complications and transfusion amounts were compared and analyzed.</p><p><b>RESULTS</b>All 100 patients undergoing TKA were involved in the result analysis. In patients without a drain, the total blood loss was (535 +/- 295) ml and the hidden blood loss was (513 +/- 290) ml, in patients with a drain, the total blood loss was (853 +/- 331) ml and the hidden blood loss (689 +/- 324) ml. The total and hidden blood loss, blood transfusion amount between drain-group and without drain-group was significantly different (P < 0.05). The difference in the incidence of infection and post-op recovery and correlative complications did not reach statistical significance.</p><p><b>CONCLUSIONS</b>In patients having primary TKA, using a drain, compared with no use of a drain, does not show us a clear advantage that make us accept it. Without a drain release could present an effective and economic method for reducing blood loss and preventing blood transfusion in patients undergoing unilateral TKA.</p>