Journal article
Optimizing Tourniquet Pressure in Upper Extremity Surgery
JOURNAL OF HAND SURGERY-ASIAN-PACIFIC VOLUME, v 26(4), pp 654-659
Dec 2021
PMID: 34789106
Featured in Collection : UN Sustainable Development Goals @ Drexel
Abstract
Background: Pneumatic tourniquet is an effective tool to achieve hemostatic control of the surgical field in upper extremity (UE) operations. Elevated pressures have been associated with adverse effects despite various methods of pressure determination. We aim to demonstrate the usage of reduced tourniquet pressures and examine factors associated with achieving reduced pressures. Methods: A prospective study was conducted (2016-2018) at a Level 1 Trauma Center and an Outpatient Surgical Center, totaling 226 operations, involving a reduction of cuff pressures over time from a standard baseline of limb occlusion pressure for UE operations. Results: A gradual reduction of pressures was successfully achieved with a mean pressure of 187 mmHg and average time of tourniquet application being 25 minutes. We found chronological surgical number and patient BMI to be significantly associated with tourniquet pressure (p < 0.05). 4.5% of cases resulted in breakthrough bleeding, but did not reliably occur with any pressure thresholds, patient demographics, or operative factors (p > 0.05, for all). Conclusions: Reduced tourniquet pressures can mitigate complications associated with tourniquet use. Our research shows reduced pressures are successful in maintaining field visibility and we encourage an adoption of pressures below 200 mm Hg in most procedures that require a tourniquet.
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Details
- Title
- Optimizing Tourniquet Pressure in Upper Extremity Surgery
- Publication Details
- JOURNAL OF HAND SURGERY-ASIAN-PACIFIC VOLUME, v 26(4), pp 654-659
- Publisher
- WORLD SCIENTIFIC PUBL CO PTE LTD; SINGAPORE
- Number of pages
- 5
- Resource Type
- Journal article
- Language
- English
- Academic Unit
- Drexel University
- Web of Science ID
- WOS:000719772600020
- Scopus ID
- 2-s2.0-85162313549
- Other Identifier
- 991021860759904721
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- Collaboration types
- Domestic collaboration
- Web of Science research areas
- Surgery