What is it about?
Although various drains have long been used for many years in total joint replacement, there is a paucity of evidence for the benefit of drain applications. Evidence suggests inconsistent practice in the use of drainage systems, whether intermittently applying suction or free of suction in the application of drainage systems, as well as the optimal timing for wound drain removal.
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Why is it important?
It aimed to perform a systematic review to develop an evidence-based nursing protocol to manage wound drainage following total joint arthroplasty.
Perspectives
Different clamping times were retrieved from the literature. A protocol was adapted for clinical application according to the summary of the retrieved information. It is suggested that clamping is performed 1 h after the insertion of suction drains post-operatively in the operating theatre. Wound drains should be clamped for 1 h if blood loss is more than 600 ml in 6 h in first 24 h. Wound drains should be clamped for 1 h if blood loss is more than 800 ml in 8 h thereafter. It is suggested that the drainage reservoir bottle should be mark and findings recorded in line with the principle of drain clamping. This means that the amount of drainage is measured and recorded every 6 h in first 24 h and every 8 h thereafter. It is suggested that wound drains should be remove before 48 h after TJR. If blood loss is less than 50 ml in past 6 h or less than 70 ml in past 8 h, the drain should be remove and the wound site should be monitored closely.
Lap Fung Tsang
Tsueng Kwan O Hospital
Read the Original
This page is a summary of: Developing an evidence-based nursing protocol on wound drain management for total joint arthroplasty, International Journal of Orthopaedic and Trauma Nursing, May 2015, Elsevier,
DOI: 10.1016/j.ijotn.2014.02.008.
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