title: Comparison between autologous blood transfusion drainage and closed-suction drainage/no drainage in total knee arthroplasty: a meta-analysis.
abstract: Autologous blood transfusion (ABT) drainage system is a new unwashed salvaged blood retransfusion system for total knee replacement (TKA). However, whether to use ABT drainage, closed-suction (CS) drainage or no drainage in TKA surgery remains controversial. This is the first meta-analysis to assess the clinical efficiency, safety and potential advantages regarding the use of ABT drains compared with closed-suction/no drainage.
  
  
  
  PubMed, Embase, and the Cochrane Library were comprehensively searched in March 2015. Fifteen randomized controlled trials (RCTs) were identified and pooled for statistical analysis. The primary outcome evaluated was homologous blood transfusion rate. The secondary outcomes were post-operative haemoglobin on days 3-5, length of hospital stay and wound infections after TKA surgery.
  
  
  
  The pooled data included 1,721 patients and showed that patients in the ABT drainage group might benefit from lower blood transfusion rates (16.59 % and 37.47 %, OR: 0.28 [0.14, 0.55]; 13.05 % and 16.91 %, OR: 0.73 [0.47,1.13], respectively). Autologous blood transfusion drainage and closed-suction drainage/no drainage have similar clinical efficacy and safety with regard to post-operative haemoglobin on days 3-5, length of hospital stay and wound infections.
  
  
  
  Autologous blood transfusion drainage offers a safe and efficient alternative to CS/no drainage with a lower blood transfusion rate. Future large-volume high-quality RCTs with extensive follow-up will affirm and update this system review.
authors.affiliation: Department of Orthopedic Surgery, Guangdong Second Traditional Chinese Medicine Hospital, No. 60 Hengfu Road, Guangzhou, Guangdong, 510095, China.
authors.forename: Kun-Hao
authors.initials: KH
authors.lastname: Hong
authors.affiliation: Department of Orthopedic Surgery, Second School of Clinical Medicine, Guangzhou University of Chinese Medicine, No. 111 Dade Road,, Guangzhou, Guangdong, 510120, China.
authors.forename: Jian-Ke
authors.initials: JK
authors.lastname: Pan
authors.affiliation: Department of Orthopedic Surgery, Second School of Clinical Medicine, Guangzhou University of Chinese Medicine, No. 111 Dade Road,, Guangzhou, Guangdong, 510120, China.
authors.forename: Wei-Yi
authors.initials: WY
authors.lastname: Yang
authors.affiliation: Department of Orthopedic Surgery, Second School of Clinical Medicine, Guangzhou University of Chinese Medicine, No. 111 Dade Road,, Guangzhou, Guangdong, 510120, China.
authors.forename: Ming-Hui
authors.initials: MH
authors.lastname: Luo
authors.affiliation: Department of Orthopedic Surgery, Second School of Clinical Medicine, Guangzhou University of Chinese Medicine, No. 111 Dade Road,, Guangzhou, Guangdong, 510120, China.
authors.forename: Shu-Chai
authors.initials: SC
authors.lastname: Xu
authors.affiliation: Department of Orthopedic Surgery, Second School of Clinical Medicine, Guangzhou University of Chinese Medicine, No. 111 Dade Road,, Guangzhou, Guangdong, 510120, China. liujun.gdtcm@hotmail.com.
authors.forename: Jun
authors.initials: J
authors.lastname: Liu
mesh_terms: D019645:Arthroplasty, Replacement, Knee / Q000009:adverse effects*; D016063:Blood Loss, Surgical / Q000517:prevention & control*; D001804:Blood Transfusion, Autologous / Q000009:adverse effects / Q000379:methods* / Q000706:statistics & numerical data; D004322:Drainage; D006454:Hemoglobins / Q000032:analysis; D006801:Humans; D007902:Length of Stay; D057725:Operative Blood Salvage / Q000009:adverse effects / Q000379:methods* / Q000706:statistics & numerical data; D011183:Postoperative Complications / Q000453:epidemiology; D011184:Postoperative Period; D016032:Randomized Controlled Trials as Topic; D013396:Suction; D016896:Treatment Outcome
chemical_list: D006454:Hemoglobins
keywords: Autologous blood transfusion; Closed-suction; Drainage; Drains; Knee arthroplasty; Knee replacement