Factors affecting wound ooze in total knee replacement

Ann R Coll Surg Engl. 2011 Jan;93(1):54-6. doi: 10.1308/003588410X12771863937124. Epub 2010 Sep 10.


Introduction: Wound ooze is common following total knee arthroplasty (TKA) and persistent wound infection is a risk factor for infection, and increased length and cost of hospitalisation.

Patients and methods: We undertook a prospective study to assess the effect of tourniquet time, peri-articular local anaesthesia and surgical approach on wound oozing after TKA.

Results: The medial parapatellar approach was used in 59 patients (77%) and subvastus in 18 patients (23%). Peri-articular local anaesthesia (0.25% Bupivacaine with 1:1,000,000 adrenalin) was used in 34 patients (44%). The mean tourniquet time was 83 min (range, 38-125 min). We found a significant association between cessation of oozing and peri-articular local anaesthesia (P = 0.003), length of the tourniquet time (P = 0.03) and the subvastus approach (P = 0.01).

Conclusions: Peri-articular local anaesthesia, the subvastus approach and shorter tourniquet time were all associated with less wound oozing after total knee arthroplasty.

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Anesthesia, Local / methods
  • Arthroplasty, Replacement, Knee*
  • Female
  • Humans
  • Male
  • Middle Aged
  • Postoperative Complications / etiology
  • Postoperative Complications / prevention & control*
  • Prospective Studies
  • Risk Factors
  • Surgical Wound Infection / etiology
  • Surgical Wound Infection / prevention & control*
  • Tourniquets
  • Treatment Outcome
  • Wound Closure Techniques*
  • Wound Healing