title: Transfusion drains versus suction drains in total knee replacement: meta-analysis.
abstract: OBJECTIVE
  The use of autologous blood transfusion drains in orthopaedic surgery has been the subject of debate for several years. The aim of this meta-analysis was to review the use of autologous blood transfusion drains in total knee replacement.
  
  
  METHODS
  The primary outcomes were as follows: the number of patients requiring homologous blood transfusion, pre-operative haemoglobin and post-operative haemoglobin days 5-7. The secondary outcome measures for the meta-analysis were drainage volume, length of hospital stay, average number of units transfused per patient, post-operative wound infection, and deep vein thrombosis.
  
  
  RESULTS
  Eight randomised controlled trials met the inclusion criteria and were included in this analysis. Autologous transfusion drains were associated with a decrease in the number of patients requiring post-operative blood transfusion (pooled odds ratio = 0.36, 95% CI = 0.15-0.85, P = 0.02), the number of units transfused per patient (weighted mean difference = -0.84 (95% CI = -1.13 to -0.56), P < 0.0001), and length of hospital stay (weighted mean difference = -0.25 (95% CI = -0.48 to -0.01), P = 0.04).
  
  
  CONCLUSIONS
  The results of our study highlight both likely clinical and economic benefits within total knee replacement surgery. The clinical benefits of autologous transfusion drains in the total knee replacement surgery suggested by this meta-analysis include a reduced requirement for post-operative blood transfusion and a shorter length of hospital stay. However, further large-scale high-powered randomized controlled trials are recommended to further elucidate subtle effects of autologous drains on post-operative outcome following total knee replacement.
  
  
  METHODS
  II.
authors.affiliation: Department of Trauma and Orthopaedic Surgery, University College London Hospitals NHS Foundation Trust, 235 Euston Road, London NW1 2BU, UK. sheraz_markar@hotmail.com
authors.forename: Sheraz R
authors.initials: SR
authors.lastname: Markar
authors.forename: Gareth G
authors.initials: GG
authors.lastname: Jones
authors.forename: Alan
authors.initials: A
authors.lastname: Karthikesalingam
authors.forename: Nicholas
authors.initials: N
authors.lastname: Segaren
authors.forename: Rahul V
authors.initials: RV
authors.lastname: Patel
mesh_terms: D000368:Aged; D019645:Arthroplasty, Replacement, Knee / Q000379:methods*; D001804:Blood Transfusion, Autologous; D005260:Female; D006801:Humans; D008297:Male; D016032:Randomized Controlled Trials as Topic; D013396:Suction
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