[Case-control study on effect of early intermittently closing drainage tube for blood loss after total knee...

To explore effect of early intermittently closing drainage tube on blood loss control after total knee arthroplasty.

Totally 60 total knee replacement patients were randomly divided into experimental group and control group according to the different drainage ways of postoperative from January 2014 to January 2015. There were 30 patients in experimental group, including 12 males and 18 females, aged from 58 to 76 years old with an average of (67.0±6.7) years old, preoperative Hb was(128.82±8.29) g/L; drainage tubes were intermittently opened for 10 minutes every 2 hours, and kept opened until 6 h after operation. There were 30 patients in control group, including 13 males and 17 females; aged from 60 to 79 years old with an average of(69.0±7.2) years old; Preoperative Hb was(126.55±8.49) g/L; tubes were kept open with negative pressure before its removing. Blood loss in operation, postoperative drainage, total blood loss, hidden blood loss, allogenic blood transfusion and local wounds during hospitalization were observed and compared.

Postoperative drainage and total blood loss in experimental group was(184±56) ml, (1 014±258) ml; and significantly lower than that of control group(476±98)ml, (1 390±383) ml(P<0.05); there were no statistical differences in interoperation blood loss and hidden blood loss(P>0.05). The incisions between two groups were healed at stage I without infection. The size of limb swelling and the number of the cases with ecchymosis in experimental group was (3.8±0.9) cm and 10 respectively; control group was (3.4±0.7) cm and 8, while there were no significant differences between two groups(P>0.05). Five patients in experimental group were performed blood transfusion, 13 patients in control group were performed blood transfusion, and with differences between two groups(P<0.05).

Intermittently closing of drainage tube after 6 h of TKA could reduce the amount of drainage, total blood loss and blood transfusion rate, and not aggravate limb swelling and subcutaneous ecchymosed. It is proved to be an effective measure to reduce bleeding after TKA.