Einfluss des Drainagesoges auf den postoperativen Verlauf nach Knieendoprothesen-Implantation

Zusammenfassung

Einleitung: In einer prospektiven randomisierten klinischen Studie sollte der Einfluss des Drainagesoges auf den postoperativen Blutverlust und den Verlauf nach Implantation von Knieendoprothesen untersucht werden.
Patienten und Methode: 116 Patienten wurden mit einer Knie-TEP einseitig versorgt. Das durchschnittliche Alter betrug 71,2 Jahre. Die Operation erfolgte mehrheitlich ohne Blutleere. Alle Patienten erhielten jeweils 2 Wunddrainagen, 57 Patienten mit Sog und 59 Patienten ohne Sog. Es wurden der postoperative Blutverlust sowie klinische und paraklinische Verlaufsparameter erfasst.
Ergebnis: Der perioperative Blutverlust erreichte im Durchschnitt 338 ml. Der postoperative Blutverlust betrug in der Gruppe ohne Sog 436 ml und in der Gruppe mit Sog 528 ml. Hinsichtlich der Hämoglobinwerte am 1. und 7. postoperativen Tag, der Drainagefördermenge 12, 24, 36 und 48 Stunden postoperativ und der Wundheilung wurden keine signifikanten Unterschiede festgestellt. Sechs Patienten in der Gruppe ohne Sog und 5 Patienten in der Gruppe mit Sog mussten Blutkonserven erhalten.
Diskussion: Die Anlage eines Soges auf das Drainagesystem hatte keinen signifikanten Einfluss auf den postoperativen Blutverlust und den Verlauf nach Knieendoprothesenimplantation. In 9 von 10 Fällen wurde kein Fremdblut benötigt.

Abstract

Problem: In a prospective randomised clinical study, we investigated the impact of drain-suction on the post-operative blood loss and on both clinical and laboratory parameters after knee replacement operations.
Patients and Method: In this study, 116 patients with unilateral implantation of knee replacements were evaluated. The patients' average age was 71.2 years. The operation was carried out mostly without tourniquet application. All patients received two wound drains, 57 with and 59 without suction. The postoperative blood loss as well as clinical and laboratory parameters were assessed.
Results: The average peri-operative blood loss amounted to 338 ml. The post-operative blood loss in the group without drain suction was 436 ml and 528 ml in the group with suction. No significant differences could be found concerning the hemoglobin values pre-operatively and on the first and seventh post-operative day, the drainage quantity 12, 24, 36, and 48 hours post-operatively, the wound healing and the CRP. Six patients in the group without and five patients in the group with drain-suction had to receive blood transfusions.
Discussion: The application of suction on the drainage system had no significant impact on the post-operative blood loss and the postoperative course. In nine out of ten cases no homologous blood was needed.

Knieendoprothetik - Drainagesog - Retransfusion - Blutverlust - Blutleere

Knee replacement - drain suction - retransfusion - blood loss - ischemia

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