Low Versus High Pressure Suction Drainage After Total Knee Arthroplasty

Study Overview
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Brief Summary
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Principal hypothesis: A low suction drainage (-50 mmHg) reduce a 25% the blood loss with respect a standard closed drainage (-700 mmHg) following total knee arthroplasty.

Detailed Description
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Secondary's hypothesis: It don't expect differences in: Incidence of hematomas Incidence in surgery wound infection Time of immobilization Duration of hospitalization The low suction drainage (-50 mmHg) will be more cost-effective than the standard closed drainage (-700 mmHg)

Official Title
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Low Versus High Pressure Suction Drainage After Total Knee Arthroplasty: a Double Blind Randomized Controlled Trial

Conditions
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Total Knee Arthroplasty

Intervention / Treatment
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* Device: low pressure suction drainage
* Device: High pressure suction drainage


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Adult knee replacement patients who agreed to participate in the study Exclusion Criteria: People that not accomplished the inclusion criteria

Ages Eligible for Study
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Minimum Age: 18 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Treatment
Allocation: Randomized
Intervention Model: Parallel Assignment
Masking: Quadruple


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Experimental: Low suction drainage<br>In the experimental group the drainage catheter was connected to a modified DRENOFAST® system. This system consisted of a sterile plastic bottle with a holding capacity of 600 mL of fluid and a negative pressure of 700mmHg. It was hermetically closed and had two connections. The DRENOFAST® modification consisted of establishing an open connection between the bottle and a wall vacuum source (normally used to administer oxygen) placed next to the patient's bed. The 50 mmHg constant negative pressure of the bottle was maintained by the wall vacuum source and verified by flow meter. | Device: low pressure suction drainage<br>* In the experimental group the drainage catheter was connected to a modified DRENOFAST® system. This system consisted of a sterile plastic bottle with a holding capacity of 600 mL of fluid and a negative pressure of 700mmHg. It was hermetically closed and had two connections. The DRENOFAST® modification consisted of establishing an open connection between the bottle and a wall vacuum source (normally used to administer oxygen) placed next to the patient's bed. The 50 mmHg constant negative pressure of the bottle was maintained by the wall vacuum source and verified by flow meter. Duration: Drains were removed after bleeding had ceased (48-72h).<br>* Other names: DRENOFAST® modified;|
| Active Comparator: High suction drainage<br>The standard DRENOFAST® system was used in the control group, and the initial negative pressure was 700 mmHg. | Device: High pressure suction drainage<br>* In order to mask the type of intervention from the patient and the investigators, both drainage systems had two drain catheters. One catheter allowed the blood to flow from the wound to the bottle. The second catheter connected the bottle to the vacuum source. In the experimental arm the second catheter was open, while in the control group it was closed. So that the system used could not be distinguished, the connection of the second catheter to the bottle was covered with opaque adhesive tape.Drains were removed after bleeding had ceased.<br>* Other names: DRENOFAST® system;|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| total post-surgical blood loss (mL) |  | from the moment after surgery until drainage catheter removal | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| blood loss (mL) in the recovery unit |  | 24-48 h | 
| Blood loss in the ward |  | 5-10 days | 
| need for a blood transfusion according to the surgeon's criteria |  | 10 days | 
| number of blood units required for transfusion |  | 10 Days | 
| post-surgical pain (using a 100mm visual analogue scale) |  | 10 days | 
| incidence of hematomas |  | 10 days | 
| infections |  | 10 days | 
| suture dehiscence |  | 10 days | 
| re-intervention due to complications in the surgical wound |  | 10 dasy | 
| venous thrombosis |  | 10 days | 
| hypotension |  | 10 days | 
| mortality |  | 10 days | 
| adverse reactions |  | 10 days | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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Blood loss, Total knee arthroplasty, Adults, Drain, Drainage system