What did the study look at?
After total knee replacement (total knee arthroplasty), a drain called a Hemovac may be used to remove blood collecting in the joint. The drain can be run under negative pressure (suction) or kept under positive pressure without suction. The study aimed to compare the effect of positive and negative pressure drain use on blood loss and transfusion needs in patients with primary osteoarthritis scheduled for total knee replacement.
How was it done?
Fifty patients who had total knee replacement between January and May 2015 were reviewed retrospectively and divided into two groups:
- Group I (24 patients): the drain was kept under positive pressure on the first day after surgery. On the second day, after passive range-of-motion exercises, it was switched to negative pressure and removed.
- Group II (26 patients): the drain was kept under negative pressure until it was removed.
Both groups followed the same rehabilitation programme after surgery. Age, sex and body mass index were similar in the two groups. Haemoglobin, haematocrit and red blood cell (erythrocyte) count were compared before surgery and for the first four days afterwards; blood collected in the drain and blood products given were also recorded.
What did it find?
- Preoperative haemoglobin (g/dl), haematocrit (%) and red cell count were similar in both groups, and remained similar during the first four days after surgery.
- There was no statistically significant difference between the groups in mean blood loss from the drain or in the amount of red cell suspension used after surgery (p > 0.05).
- Transfusion with donor blood (allogeneic red cell suspension) was given to 9 of 24 patients in Group I and 13 of 26 patients in Group II. The need for transfusion did not differ significantly between the groups (p > 0.05).
The authors' conclusion
The authors concluded that, based on this study, early use of a positive pressure Hemovac drain after surgery does not reduce blood loss, the amount of allogeneic red cell suspension transfused or the need for allogeneic transfusion.
Reference
Basaran HS, Dasar U, Satilmis BA, Bicimoglu A, Akkaya M, Gürsoy S, Erkilinc M. 2016. Usage of Positive Pressure Hemovac Drain following Total Knee Arthroplasty: Reduce Blood Loss or Not. SM Journal of Orthopedics 2(1):1-3.
DOI: 10.36876/smjo.1027
Free full text: SM Journal of Orthopedics
This summary is based on the article's abstract.
This article summarises a published scientific paper for general information; it does not replace an examination or a personal medical assessment. Please consult your doctor about your symptoms.
