Non-continuous versus continuous wound drainage after total knee arthroplasty: a meta-analysis

Abstract

So far, controversy still exists regarding the use of non-continuous or continuous wound drainage after total knee arthroplasty. The aim of this study was to assess the efficacy and safety of these two drainage techniques after total knee arthroplasty. We searched the established electronic literature databases of Pubmed, Embase, Cochrane Library, CNKI, VIP and WANFANG. Nine RCTs including a total of 761 patients involving 811 knees were eligible for this meta-analysis. Our results showed that non-continuous drainage was associated with less haemoglobin loss (WMD, -0.43, 95 % CI -0.62 to -0.24; P < 0.00001) and postoperative visible blood loss (WMD, -305.09, 95% CI -408.10 to -202.08; P < 0.00001) compared with continuous drainage. No significant difference was found between the two groups in terms of range of motion (WMD, 0.99, 95% CI -1.01 to 2.98; P = 0.33), incidence of blood transfusion (OR, 0.63, 95% CI 0.38 to 1.06; P = 0.80) or postoperative complications (OR, 1.09, 95% CI 0.35 to 3.40; P = 0.89). The existing evidence indicates that non-continuous drainage can achieve less haemoglobin loss (especially the four- to six-hour drain clamping) and postoperative visible blood loss with no increased risk of postoperative complications compared with continuous drainage.