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

Abstract

Background TKA can involve substantial bleeding, and the issue regarding whether vacuum drainage should be used during TKA continues to be debated as both methods have disadvantages. Questions/purposes We therefore asked whether subcutaneous indwelling vacuum drainage is advantageous over intraarticular indwelling vacuum drainage in terms of blood drainage, bleeding-related complications, and functional outcomes in primary TKA. Patients and methods We randomized 111 patients undergoing TKAs to have either a subcutaneous indwelling or an intraarticular indwelling catheter and compared the two groups for blood loss (hemoglobin decrease, transfusion requirements, hypotension episode), incidence of wound problems (requirements for dressing reinforcement,

What is the Ideal Route of Administration of Tranexamic Acid in TKA? A Randomized Controlled Trial

“…After completing prosthesis fixation, the tourniquet was deflated and arterial bleeding was cauterized. A closed suction drain was placed subcutaneously with the intention to reduce blood loss and wound complication risk [44]. A compressive dressing then was applied with a CryoCuff (Howmedicare, Seoul, Korea) and knee immobilizer during the first 24 hours.…”

Does the suction drain diameter matter? Bleeding analysis after total knee replacement comparing different suction drain gauges

“…The data in the study by Seo et al 2 suggest that subcutaneous drainage is similar to that used for closed suction intra-articular drainage, with equivalent blood loss and without adverse effects on functional results; therefore, the use of SD in the subcutaneous is a reasonable option against intra-articular.…”

“…Substantial bleeding can occur in the subcutaneous and intra-articular space after TKR; this event can lead to blood transfusions, with their potential complications 2 . Drainage is commonly used with the theoretical purpose of preventing hematomas, which, in turn, may decrease joint mobility and reduce local tissue perfusion, increasing the possibility of infection.…”

Comparison Between Subcutaneous Closed-suction Drainage and Conventional Closed-suction Drainage in Adolescents Idiopathic Scoliosis Patients Undergoing Posterior Instrumented Spinal Fusion

“…1 Subcutaneous closed-suction drainage has been reported to be a reasonable alternative to intra-articular indwelling closed-suction drainage and to not employing a postoperative drain in knee arthroplasty. 7 It has also been used in other types of surgery including breast and thyroid. 8,9 This prospective, randomized study was designed to determine the efficacy of subcutaneous closed-suction drainage in reducing blood loss and to compare wound related complications to conventional closed postoperative drainage in adolescent idiopathic scoliosis patients undergoing posterior instrumented fusion.…”