Comparison between 1-hour and 24-hour drain clamping using diluted epinephrine solution after total knee arthroplasty.

Yamada K, Imaizumi T, Uemura M, Takada N, Kim Y
J Arthroplasty 2001;16(4):458-462.
Review by : P. Earnshaw, R. K. Spence
NATA Review
Another paper concerning the use of drains in total knee arthroplasty. Not a large number of cases, but interesting comments on the ongoing controversy, i. e., Should drains be used at all? Should the blood be reinfused? How much? When? Allogeneic transfusion should normally be needed in less than 10% of primary TKA’s.

– P. Earnshaw.

This article combines the use of epinephrine to minimize blood loss as taught by Carl Nelson with variations in clamping time of drains following total knee arthroplasty. Clamping beyond 1 hour had no impact on blood loss or transfusion but did affect overall complication rates. It is notable that only 3 patients out of 44 were transfused. In itself, this represents a significant advance over not too distant practices of transfusing the majority of such patients.

– R. K. Spence.

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