Routine closed suction drainage and postoperative laboratory studies have long been tenets of most TJA protocols. However, recent literature has called into question whether either is necessary with modern outpatient TJA clinical pathways. Demographic, cost, and readmission data for 2,605 primary unilateral TJA cases was collected retrospectively and analyzed prior to and after a protocol change where routine closed suction drains and postoperative laboratory tests were eliminated. This protocol change was designed to treat all primary TJA like outpatients regardless of their admission status. Drain usage changed from routine to selective based on hemostasis. Lab studies changed from routine to selective for patients on warfarin for VTE prophylaxis (INR), with ASA 4 or 5 status (BMP), and with a hematocrit < 27% in the recovery room after THA (CBC).Background
Methods
