Does temporary clamping of drains following knee arthroplasty reduce blood loss? A randomised controlled trial

Subcutaneous versus Intraarticular Indwelling Closed Suction Drainage after TKA: A Randomized Controlled Trial

“…Several studies have determined optimal drain clamping times, but recommendations varied and included no clamping [21], clamping for 1 hour [37,47], 10-minute clamp releases every 2 hours [33], clamping for 4 hours [41,43], and clamping for 20 hours [38]. We cannot comment on the effects of clamping time on the intraarticular indwelling method, but mean drained volume in our study (352 mL) compares with those (253-843 mL) reported previously [21,33,37,38,41,43,47]. Third, as mentioned above, our cohort size was sufficient to detect differences in drained volumes, hemoglobin level, and Data are presented as percentages of knees with a complication, with numbers of knees in parentheses.…”

The Role of Drainage After Total Knee Arthroplasty

“…No matter clamping or not, most of the patients showed similar postoperative hemoglobin levels. (Kiely et al 2001;Shen et al 2005;Eum et al 2006;Tsumara et al 2006;Stucinskas et al 2008) Only one study revealed higher postoperative hemoglobin level in the clamping group. (Raleigh et al 2007) The number of patients requiring transfusion was provided in four studies (Shen et al 2005;Eum et al 2006;Tsumara et al 2006;Stucinskas et al 2008).…”

“…The initial clamping provides a temporary tamponade effect, as well as the delayed release prevents hematoma formation. An earlier study (Kiely et al 2001) about the clamping drainage was reported in 2001 and it claimed that there was no significant difference between the clamping and non-clamping drainage groups in volume of drained blood, transfusion requirements, knee motion or wound status. However, several following studies (Shen et al 2005;Tsumara et al 2006;Raleigh et al 2007;Stucinskas et al 2008) showed that the drained volume was decreased by temporarily clamping the drain tubes.…”

Blood Transfusion in Knee Arthroplasty

“…Along the same lines, another study states that delaying the opening-up of drainages 4 hours; drainage decreases in a statistically significant way (Shen et al, 2005). On the other hand, some authors conclude that clamping drains during first 2 postoperative hours does not influence within drained quantity, nor transfusion number, or mobility, or surgical wound complications (Kiely et al, 2001). Study by Leemann et al affirms that after 6 hours drainage can be removed as 78% of bleeding has been already drained (Leeman et al, 2006).…”