Determination of blood loss after clamping drainpipe in total knee arthroplasty

OBJECTİVE: We aim to decrease the blood loss from the drainpipe and blood transfusion necessity by clamping the drainpipe in the first two hours after the total knee arthroplasty (TKA) operation.MATERIAL AND METHODS: Seventy-one patients who underwent TKA operation were included into the study. The patients were divided into 2 groups randomly; Group I: 32 patients 44 knees, Group II: 39 patients 51 knees. In Group I, drainpipe was clamped in the first 2 hours just after the TKA operation and then the clamp was opened, and the drainpipe was pulled out at the postoperative 48th hour. In Group II, postoperative bleeding control was performed and the drainpipe was released after the wound was closed, and the drainpipe was pulled out at the postoperative 48th hour. Preoperative hemoglobin levels, hemoglobin levels in the postoperative 1st, 2nd and 3rd days, blood loss via drainpipe and total number of blood transfusions in both groups were added and compared each other.RESULTS: Blood loss via drainpipe after TKA was 689,125ml (115-1818) in Group I and 761,897ml (125-1970) in Group II and there was no statistically significant difference between them (p=485). In Group I, while no blood transfusion was performed to 11 patients, a total number of 43 units of blood transfusion was performed to 21 patients and mean number of blood transfusion unit per patient was 1,34 unit. In Group II, while no blood transfusion was performed to 9 patients, a total number of 57 units of blood transfusion was performed to 30 patients and mean number of blood transfusion unit per patient was 1,49 unit. When mean numbers of blood transfusion unit per patient in both groups were compared statistically, no significant difference was determined (p=473). In Group I, mean value of preoperative hemoglobin levels was 13,4gr/dl, mean values of hemoglobin levels in the postoperative 1st, 2nd and 3rd days were 10,7gr/dl, 10,0gr/dl and 10,4gr/dl respectively. In Group II, mean value of preoperative hemoglobin levels was 13,2gr/dl, mean values of hemoglobin levels in the postoperative 1st, 2nd and 3rd days were 10,6gr/dl, 9,9gr/dl and 9,7gr/dl respectively. No statistically significant difference was determined between these values. P values of preoperative, 1st, 2nd and 3rd days were as follows respectively: (p=668, p=904, p=946, p=244).CONCLUSION: The method of temporary drainpipe clamping for 2 hours just after TKA operation did not result in any change in blood loss, hemoglobin decrease and blood transfusion necessity when compared with the patients who underwent postoperative bleeding control.