Low- vs. high-pressure suction drainage after total knee arthroplasty: A double-blind randomized controlled trial

Rafael Calvo, Ma José Martínez-Zapata, Gerard Urrútia, Ignasi Gich, Marcos Jordán, Alejandro Del Arco, Francisco Javier Aguilera, Fernando Celaya, Juan Sarasquete, Joan Majó, Xavier Bonfill

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5 Citations (Scopus)


Aim. The aim of this study was to assess the efficacy of continuous low-pressure suction drainage compared with closed high-pressure suction following total knee arthroplasty. Background. Closed wound drainage systems are used in surgical interventions to reduce the incidence of haematomas, promote wound healing and reduce infections. However, evidence shows that using a closed wound drainage system can increase transfusion requirements. Data sources. A randomized, double-blind and parallel controlled trial was performed. Adult knee replacement patients recruited between May 2006 and March 2007 were assigned to receive low-pressure suction of 50mmHg (experimental drainage) or high-pressure suction of 700mmHg (comparator drainage). Methods. The primary outcome was total blood loss after surgery. Secondary outcomes were incidence of transfusion, complications and mortality. Statistical analysis was based on an intention-to-treat approach. Linear regression was performed to account for factors that could influence blood loss. Results. A total of 169 patients were included. Mean age was 73 (±6) years, 128 women and 41 men. A total of 84 patients were randomized to the experimental drainage and 85 to the comparator drainage. Analysis showed a total postoperative blood loss of 541·8mL in the experimental group and 524·4mL in the comparator group (P=0·734). The only factor that showed an association with blood loss was the length of surgery. Linear regression did not show differences between the groups. Conclusion. Continuous low-pressure suction of 50mmHg is not more effective than the higher aspiration pressure system to diminish the blood loss in total knee arthroplasty. The results do not support any change in current nursing practice relating to the use of this drain system. © 2011 Blackwell Publishing Ltd.
Original languageEnglish
Pages (from-to)758-766
JournalJournal of Advanced Nursing
Issue number4
Publication statusPublished - 1 Apr 2012


  • Blood
  • Drainage
  • Knee arthroplasty
  • Orthopaedic nursing


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