Mirzatolooei Fardin, Tabrizi Ali, Gargari Maryamsadat Mokaram
Urmia university of Medical Sciences, Urmia, Iran.
Arch Bone Jt Surg. 2018 Jan;6(1):47-51.
The role of wound drainage after total knee arthroplasty is still considered controversial as although closed drainage systems have been believed to be effective in decreasing the post-operative complications, they could also facilitate the bleeding and increase the rate of transfusion and infection. We have conducted the current study to compare the outcomes superficial subcutaneous, one deep, and two deep drain techniques after total knee arthroplasty.
Between 2014 and 2015 sixty consecutive patients were prospectively selected and underwent primary total knee arthroplasty. Patients randomized to receive one superficial, one deep and two deep drains at the end of operation. Tourniquet was used and opened at the end of the surgery after dressing. Patients were studied for volume of blood loss, hemoglobin drop, number of transfusion, and any complications. Knee range of motion and diameter were measured and compared with contralateral side in all cases at the end of the third day.
There was no statistical difference regarding red blood cell volume loss, Hb drop, and transfusion rate between groups. Patients in one superficial group had the most sever post-operative ecchymosis. Knee flexion and swelling were the same in all groups. Patients in one superficial drain group had the worst VAS for the pain. Need for early blood transfusion was significantly higher in two deep drain group. In one deep drain group returned back to operating room for sever hemarthrosis and wound dehiscence was occurred in a patient. One patient in one deep group had also developed mild thrombo-emboli.
Regarding the blood volume loss after total knee arthroplasty there is no difference between superficial drainage and even more effective intra-articular techniques. Outcome and complication rates are the same. II.
全膝关节置换术后伤口引流的作用仍存在争议，因为尽管封闭式引流系统被认为可有效降低术后并发症，但它们也可能导致出血增加、输血率上升以及感染风险增加。我们开展了本研究，以比较全膝关节置换术后浅表皮下、单根深部和两根深部引流技术的效果。
2014年至2015年期间，前瞻性选取了60例连续患者，他们均接受了初次全膝关节置换术。患者在手术结束时随机接受一根浅表引流管、一根深部引流管和两根深部引流管。术中使用了止血带，并在手术结束包扎后松开。对患者的失血量、血红蛋白下降情况、输血次数以及任何并发症进行了研究。在第三天结束时，测量所有病例的膝关节活动范围和直径，并与对侧进行比较。
各组之间在红细胞体积丢失、血红蛋白下降和输血率方面无统计学差异。单根浅表引流组患者术后瘀斑最严重。所有组的膝关节屈曲和肿胀情况相同。单根浅表引流组患者的疼痛视觉模拟评分（VAS）最差。两根深部引流组早期输血的需求显著更高。单根深部引流组有一名患者因严重关节积血返回手术室，且有一名患者发生了伤口裂开。单根深部引流组有一名患者还出现了轻度血栓栓塞。
关于全膝关节置换术后的失血量，浅表引流与更有效的关节内技术之间没有差异。结果和并发症发生率相同。二、
