The role of drains and tourniquets in primary total knee replacement: a comparative study of TKR performed with drains and tourniquet versus no drains and XXXX and saline infiltration.

@entity1 @entity1425 @entity190
One hundred fifteen consecutive @entity1 undergoing TKR were divided into two groups to determine whether @entity190 and transfusion in total knee replacement (TKR) using @entity1425 with saline infiltration would be less than TKR with tourniquet and drain. Group 1, composed of 60 @entity1 , received 2.5 mg of 1:1000 @entity1425 diluted in 500 mL of normal saline, which was infiltrated into the skin, subcutaneous tissues, and capsule before surgical incision. No tourniquets or postoperative drains were used. Group 2, composed of 55 @entity1 , had a tourniquet and postoperative drain. Thromboprophylaxis with low molecular weight heparin also was used. Pre- and postoperative hemoglobin, @entity190 , hematocrit, and transfusion requirements were studied in both groups; in group 2, @entity190 in the drains also was noted. Average preoperative hemoglobin and hematocrit in the two groups were 13.7 g/dL and 39.3 g/dL, respectively, and 13.5% and 39%, respectively. Average intraoperative @entity190 was 290 mL in group 1 and 377.7 mL in group 2 (P<.005). Postoperative @entity190 in group 1 was <50 mL based on dressing soakage and 297.7 mL in group 2 (P<.005). Average postoperative hemoglobin and hematocrit in the two groups were 10.6 g/dL and 8.4 g/dL, respectively, and 35.4% and 31.1%, respectively. Transfusion rates were 3.3% and 23.6%, respectively (P<.005). The average volume transfused was 1.2 U. @entity1425 and saline infiltration is safe and helps reduce intraoperative @entity190 . Suction drain use for surgical wounds after primary, uncomplicated TKR is questionable.
