Abstract
The use of wound drains in arthroplasty patients is controversial. Previous work including a meta analysis looking at closed drainage systems has shown no benefit in their use. It is postulated that retransfusion drains may offer an advantage over closed drains and cut allogenic transfusion requirements and aid wound healing. This study was designed to assess the use of retransfusion drains in hip and knee replacement patients and prove the null hypothesis that there is no difference in post op haemaglobin levels or transfusion with their use.
Following an initial pilot audit of blood drainage in such patients we designed a protocol for a prospective trial. In a prospective randomised controlled study we evaluated the use of retransfusion drains in primary hip and knee arthroplasty patients. Eighty patients were randomised to removal of the drain at six or twenty-four hours post op, to assess the most efficient and beneficial use of such drains. The rate of blood drainage, post-operative haemaglobin (Hb) levels, blood transfusion, hospital stay, complications and rehabilitation observed. The two groups were comparable, have a follow up of two years and all attempts to control variables were made.
The drop in haemaglobin, hospital stay, complications and rehabilitation between both groups revealed no significant difference in all respects. Wound healing appeared better in six-hour group for hip and knee patients. There is no effect of type of joint or age on the drop in Hb. The TKR patients drained sig. more blood than the THR patients. The rate of blood loss is discussed. The amount of blood drained that was retransfused was 94% efficient. The allogenic transfusion rates were higher in the six-hour knee group. Three patients required post operative antibiotic but at latest follow up all patients were reported as having no problems and no evidence of infection.
This study concludes that retransfusion drains offer no advantage in the arthroplasty patients’ care.
Correspondence should be addressed to: Cynthia Vezina, Communications Manager, COA, 4150-360 Ste. Catherine St. West, Westmount, QC H3Z 2Y5, Canada
