Revisiting Suction Drain in Primary TKR - A Necessary Safeguard or An Obsolete Practice

Abstract Introduction: Traditional use of suction drains in primary Total Knee replacement (TKR) is still in practice even with the evolving surgical techniques and postoperative care. Many studies have proven similar results without using drain in the past. This study aims to compare the results in our hospital and to find out the potential complications. Aim: This study seeks to compare the use of drain versus no drain with regard to blood loss, transfusion rates, post-operative pain, wound complication and number of days of hospital stay in primary total knee replacement patients in Believers Church Medical College. Materials & Methods: 100 consecutive patients with drain and without drain each fulfilling the inclusion criteria was taken from the database of our institution from 2022 January to 2022 December. A retrospective descriptive study was conducted with regards to tourniquet time, pre and post-operative hemoglobin level, blood transfusion rates, amount of drain, wound related complication and pain-score. Results: TKR without drain had lower blood loss, transfusion rate, less postoperative pain and less hospital stay compared with those with drain however echymosis and effusion was present in few patients which subsided in 3 weeks without any intervention. This study showed no added advantage of using drain in relation to wound complication and postoperative rehabilitation. however, the drain related complication, increased blood transfusion and increased hospital stay may cause increased financial burden on patients. Conclusion: This study showed early postoperative mobilization, less haemoglobin drop, low transfusion rates and lesser number of hospital stay in patients without drain. The study also showed no added advantage of using drain in primary total knee arthoplasty. As with the increasing environmental concerns and increasing cost of healthcare we as caregivers should be judicious in the use of drain(plastic) when similar results can be achieved without it. However, more studies with larger cohort and longer follow-up may be needed to establish the results.