Tourniquet Use in Extremity-Based Microsurgery

John Corbett; Madeline Rocks; Meagan Wu; Stephanie Nemir; Jose Castro; Gilberto Gonzalez; Ali Azad; Jacques Hacquebord; Shawn Diamond

doi:10.1055/a-2132-9804

Journal of Reconstructive Microsurgery, Inhaltsverzeichnis

J Reconstr Microsurg 2024; 40(03): 227-231
DOI: 10.1055/a-2132-9804

Original Article

Tourniquet Use in Extremity-Based Microsurgery

John Corbett^*

¹Department of Surgery, George Washington University, Washington, Dist. of Columbia

²Department of Surgery, Texas Tech University Health Science Center El Paso, El Paso, Texas

,

Madeline Rocks ^*

⁴Division of Hand Surgery, NYU Langone Health Department of Orthopedic Surgery, New York, New York

,

Meagan Wu

⁶Sidney Kimmel Medical College, Thomas Jefferson University Philadelphia, Pennsylvania

,

Stephanie Nemir

²Department of Surgery, Texas Tech University Health Science Center El Paso, El Paso, Texas

,

Jose Castro

²Department of Surgery, Texas Tech University Health Science Center El Paso, El Paso, Texas

,

Gilberto Gonzalez

³Department of Orthopaedic Surgery and Rehabilitation, Texas Tech University Health Sciences Center El Paso, El Paso, Texas

,

Ali Azad

⁴Division of Hand Surgery, NYU Langone Health Department of Orthopedic Surgery, New York, New York

,

Jacques Hacquebord

⁴Division of Hand Surgery, NYU Langone Health Department of Orthopedic Surgery, New York, New York

⁵NYU Langone Health Hansjörg Wyss Department of Plastic Surgery, New York, New York

,

Shawn Diamond

²Department of Surgery, Texas Tech University Health Science Center El Paso, El Paso, Texas

› Institutsangaben

Abstract

Background The use of tourniquets and their role in extremity-based microsurgery has not been thoroughly investigated. The purpose of this study was to investigate tourniquet use and its associated outcomes and complications. The authors hypothesize that tourniquets enhance visualization, bloodless approaches to vessel harvest, flap elevation, and anastomosis without added complications.

Methods A retrospective chart review was completed for patients who had undergone extremity-based microsurgery with the use of a tourniquet between January 2018 and February 2022 at two large academic institutions. Demographic characteristics, initial reasons for surgery, complications, and outcomes were recorded. Patients were separated into groups based on tourniquet use during three operative segments: (1) flap elevation, (2) vessel harvest, and (3) microvascular anastomosis. An internal comparison of complication rate was performed between cases for which a tourniquet was used for one operative segment to all cases in which it was not used for the same operative segment. Univariate and multivariate statistical analyses were performed to identify statistically significant results.

Results A total of 99 patients (106 surgeries) were included in this study across sites. The mean age was 41.2 years and 67.7% of the patients were male. The most common reason for microsurgical reconstruction was trauma (50.5%). The need for an additional unplanned surgery was the most common surgical complication (16%). A total of 70, 61, and 32% of procedures used a tourniquet for flap elevation, vessel harvest, and for anastomosis, respectively. Statistical analyses identified no difference in complication rates for procedures for which a tourniquet was or was not used for interventions.

Conclusion Based on these results, the authors state that tourniquets can be utilized for extremity-based microsurgery to enable bloodless dissection without the concern of increased complication rates.

Keywords

tourniquet - extremity-based microsurgery - flap elevation - vessel harvest - microvascular anastomosis

Volltext

Referenzen

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