Does Draining the Post Operative Hematoma Have an Impact in Tka Patients by Syed Kamran Ali Shah in BJSTR

Does Draining the Post Operative Hematoma Have an Impact in Tka Patients by Syed Kamran Ali Shah in BJSTR

Abstract

Objective: To determine the effectiveness of no drain placement compared to use of closed suction drain post TKA, in terms of wound related complications and blood loss.

Methods: This prospective observational study was conducted at Liaquat National Hospital, Karachi, from April 2016 to March 2017. Clinical data including co-morbidities, pre operative haemoglobin and indication for TKA were collected in the Performa. All patients randomized into even and odd number sub divided into Group A (without post operative drain) and Group B (with closed suction drains). Tourniquet were applied in all cases, after completion of TKA tourniquet were released and bleeding points controlled. Group B patients were received closed suction drains followed by wound closure, whereas Group A patients undergo direct closure without drain placement. Pre operative haemoglobin were collected and repeated on 1st and 5th postoperative day. At 5th postoperative day dressing were changed and wound assessed for any wound related complications and total number of blood transfusions required also noted. Data were collected manually and analysed using SPSS version 19.

Result: Out of 120 enrolled patients, 28(23.33%) were male and 92 (76.66%) females, overall mean age (62.92±8.73). In group A 41 (68.33%) patients experienced wound edema in comparison to group B which had 7(11.66%) patients with wound edema. Mean haemoglobin drop pre and post operatively on 5th day were 2.000±0.972 mg/dl in group A compared to group B 2.713±1.042 mg/dl. Haemoglobin drop among two groups were significant, Mean total number of blood transfusion required in group A were 1.53 ±0.833 pints in compared to group B which were 2.48 ±0.676 pints and found statistically significant.

Conclusion: Without use of drain have drastically decrease the rate of transfusion and perhaps the transfusions related complications which includes cross match and hypersensitivity reactions and also the transfer of blood born diseases which can be lethal to life. But contrary there were some wound related complications which can be addressed by homeostasis and meticulous wound closure.

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