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Related Experiment Videos

Closed suction drainage following knee arthroplasty. Effectiveness and risks.

D Willemen¹, J Paul, S H White

¹Nuffield Orthopaedic Centre, John Radcliffe Hospital, Headington, Oxford, England.

Clinical Orthopaedics and Related Research

|March 1, 1991

Summary

Removing suction drains after total knee arthroplasty (TKA) at 24 hours is optimal. Continuing drainage beyond 24 hours offers no benefit and increases bacterial contamination risk.

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Area of Science:

Orthopedic Surgery
Infectious Disease

Background:

Suction drains are commonly used after total knee arthroplasty (TKA).
The optimal duration for drain removal after TKA remains debated.
Prolonged drainage may increase infection risk.

Purpose of the Study:

To determine the optimal timing for suction drain removal following TKA.
To evaluate the impact of drain duration on fluid drainage volume and bacterial contamination.

Main Methods:

A prospective, randomized study involving 41 TKAs.
TKAs were allocated to either 24-hour or 48-hour closed suction drainage.
Drain tips were cultured quantitatively to assess bacterial growth.

Main Results:

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85% of total fluid drainage occurred within the first 24 hours in the 48-hour group.
Mean drainage volume in the second 24-hour period was only 50 ml.
No bacteria were isolated from drain tips at 24 hours, but 25% showed growth at 48 hours (coagulase-negative staphylococci, Staphylococcus aureus).
Clinical wound healing was comparable between groups.

Conclusions:

Continuing suction drainage beyond 24 hours after TKA provides no significant benefit.
Early drain removal at 24 hours minimizes the risk of bacterial contamination.
Optimal TKA drain management involves removal at 24 hours.