Martin A, Prenn M, Spiegel T, Sukopp C, von Strempel A
Lehrkrankenhaus der Universität Innsbruck, Landeskrankenhaus Feldkirch, Orthopädie und orthopädische Chirurgie, Feldkirch, Austria.
Z Orthop Ihre Grenzgeb. 2004 Jan-Feb;142(1):46-50. doi: 10.1055/s-2004-817656.
The benefits of postoperative wound drainage in patients with total knee arthroplasty (TKA) with regards to mobilisation and wound healing were studied. We wanted to determine the efficacy of an autologous blood retransfusion system.
150 patients with TKA were divided into three groups of 50 patients: A) three wound drainages with an autotransfusion system and suction; B) no wound drainage; C) one intraarticular wound drainage without suction. Hemoglobin values, blood transfusion requirements, blood loss, postoperative range of motion, Insall knee score and rate of complications were observed and recorded. All patients were operated without tourniquets for lower blood loss.
In the group of patients with wound drainage and a retransfusion system the requirement of postoperative additional blood transfusion was not significantly less than in the group without wound drainage. Group A had the highest blood loss of all. The group without wound drainage had more hematomas and wound healing complications. Best results were observed within the group with one intraarticular drainage without suction. The rate of complications was not increased and the blood transfusion requirements were the lowest.
This study shows that total knee replacement involving one intraarticular wound drainage without suction attains the best results.
研究全膝关节置换术（TKA）患者术后伤口引流在活动能力和伤口愈合方面的益处。我们想确定自体血回输系统的疗效。
150例TKA患者被分为三组，每组50例：A组）使用自动输血系统和吸引装置进行三次伤口引流；B组）不进行伤口引流；C组）进行一次关节内伤口引流且不使用吸引装置。观察并记录血红蛋白值、输血需求、失血量、术后活动范围、Insall膝关节评分及并发症发生率。所有患者手术时均未使用止血带以减少失血。
伤口引流及回输系统组患者术后额外输血需求并不显著低于无伤口引流组。A组失血量在所有组中最高。无伤口引流组出现更多血肿及伤口愈合并发症。在进行一次关节内无吸引引流的组中观察到最佳结果。并发症发生率未增加且输血需求最低。
本研究表明，全膝关节置换术采用一次关节内无吸引伤口引流可获得最佳效果。
