Impact of Drain Use and Tourniquet Release Timing on Blood Loss, Operative Time, and Wound Complications in Total Knee Arthroplasty
Introduction: This study aimed to investigate the effects of different practices regarding tourniquet release timing and drain usage in primary total knee arthroplasty (TKA) on intraoperative and post-operative blood loss, operative time, and post-operative complications. Methods: A retrospective r...
| Main Authors: | , , , , , , , |
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| Format: | Article |
| Language: | English |
| Published: |
Galenos Yayinevi
2025-02-01
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| Series: | İstanbul Medical Journal |
| Subjects: | |
| Online Access: | https://istanbulmedicaljournal.org/articles/impact-of-drain-use-and-tourniquet-release-timing-on-blood-loss-operative-time-and-wound-complications-in-total-knee-arthroplasty/doi/imj.galenos.2025.60963 |
| Summary: | Introduction: This study aimed to investigate the effects of different practices regarding tourniquet release timing and drain usage in primary total knee arthroplasty (TKA) on intraoperative and post-operative blood loss, operative time, and post-operative complications.
Methods: A retrospective review was conducted on the records of patients who underwent TKA by one of four authors (E.Ö., S.Y., F.E.M., S.A.A.) from 01.09.2023 to 01.11.2024. Patients were divided into three groups: group A, early tourniquet release without drain use (E.Ö.); group B, early tourniquet release with drain use (F.E.M.); group C, late tourniquet release with drain use (S.A.A. and S.Y.). Patients with revision TKAs or use of constrained prosthesis, or removal of hardware were excluded. A total of 102 patients were identified. Demographic, blood loss, and operative time data were collected. The groups were compared regarding changes in pre- and post-operative hemoglobin (Hb) levels, operative times, and post-operative complications.
Results: No significant differences in age, gender distribution, or pre-operative and post-operative Hb levels were observed between the groups (p>0.05). All groups showed a significant decrease in post-operative Hb levels compared with pre-operative values (p<0.05), but the Hb change was not statistically different between groups (p>0.05). The operative time was significantly longer in group B (122.0±18.6 minutes) than in groups A (101.0±14.3 minutes) and C (97.6±21.5 minutes) (p<0.05). Wound complications included prolonged wound drainage in group A, acute infection in group B, and superficial infection in group C, with no significant differences in complication rates between groups (p>0.05).
Conclusion: Our results showed that different tourniquet release timings and drain use did not significantly impact perioperative blood loss but may affect the operative time. Specifically, drain use and early tourniquet release were associated with longer operation times. These findings suggest that late tourniquet release minimizes the operative time while maintaining comparable blood loss. This approach may be particularly beneficial in busy surgical settings where reducing operative time is a priority, without compromising patient safety or clinical outcomes. |
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| ISSN: | 2619-9793 2148-094X |