Drain Anchoring and Removal Technique Without Change of Dressing in Transtibial Amputation

Routine or selective insertion of drains following below knee or transtibial (TA) amputations is not uncommon in vascular patients who are often on antiplatelet agents or anticoagulants prior to their operation. There is no robust evidence regarding dressings and drains used in the management of TA stump. Routine use of drains may help to obliterate dead space, and reduce haematoma formation and ultimately wound infection. The drain, when inserted, is customarily removed within 48 hours to eliminate any risk of increased infection risk that may be associated with use of drains. It is preferable not to suture the drain to the skin so that removal does not disturb the dressings and bandages prematurely. On the other hand, the drain should remain in place for the intended duration. This study describes a technique that fixes the drain securely to allow its removal without the need to change the dressing. This technique applies only when soft dressings like orthopaedic wool and crepe bandage have been employed e a common practice in the UK.