Tourniquet Release Prior to Dressing Application Reduces Blistering Following Total Knee Arthroplasty

Heller, Snir; Chen, Antonia F.; Restrepo, Camilo; Albert, Emily; Hozack, William J.

doi:10.1016/j.arth.2015.02.035

Cited by 20 publications

(16 citation statements)

References 17 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Watanabe et al [3] reported that 19 cases of venous thromboembolism occurred after 42 TKAs with a conventional cuff, compared with 6 out of 32 TKAs in our elastic cuff group. Heller et al [22] reported that 18 skin blisters were observed after 335 TKAs (5.4%), compared with none of the elastic cuff group in our study. Finally, the LOP system and elastic cuff effectively provided a bloodless surgical field during TKA.…”

Section: Discussioncontrasting

confidence: 49%

“…First, our tourniquet pressure based on the LOP system and elastic cuff (246.1 ± 23.7 mmHg) was markedly lower than that with conventional application of tourniquet during TKA in previous studies (275–350 mmHg) [3, 16, 22]. Second, it showed the lower incidence of complications related to the tourniquet.…”

Section: Discussionmentioning

confidence: 64%

“…Although there was no control group using typical tourniquet pressure of 300 mmHg in this study, our tourniquet application strategy based on the LOP system and elastic cuff has some benefits in terms of safety and efficacy compared to conventional application of tourniquet during TKA in previous studies [3, 16, 21, 22]. First, our tourniquet pressure based on the LOP system and elastic cuff (246.1 ± 23.7 mmHg) was markedly lower than that with conventional application of tourniquet during TKA in previous studies (275–350 mmHg) [3, 16, 22].…”

Section: Discussionmentioning

confidence: 95%

See 2 more Smart Citations

Efficacy and safety of a new elastic tourniquet cuff in total knee arthroplasty: a prospective randomized controlled study

Lee

2017

BioMed Eng OnLine

View full text Add to dashboard Cite

BackgroundThe effects of cuff shape, timing of tourniquet application, and automated systems using limb occlusion pressure (LOP) have been reported to minimize the appropriate tourniquet pressure. However, studies on the raw material of the cuff itself to reduce the complications related to the tourniquet have been very rarely reported. The purpose of this study is to report the efficacy and safety of a tourniquet system with a new elastic cuff in which pressure is set with LOP in total knee arthroplasty (TKA).MethodsA total of 63 patients who underwent primary TKA for osteoarthritis were enrolled from July to December 2015. Thirty-one patients were allocated to the new elastic cuff group and 32 in the conventional cuff group. Bloodless surgical field, pain visual analog scale (VAS) on the thigh, thigh circumference, range of motion, incidence of deep vein thrombosis, and muscle enzyme level after surgery were checked and compared between the 2 groups.ResultsOnly 1 of the 31 patients in the elastic cuff group required more pressure for obtaining a bloodless surgical field, whereas 4 of the 32 patients in the conventional cuff group required more pressure to complete surgery without being disturbed by sustained bleeding. Two patients in the conventional cuff group needed treatment for blisters and bullae at the tourniquet application site. There was no difference in pain VAS score, thigh circumference, range of motion, incidence of deep vein thrombosis, and level of muscle enzyme.ConclusionsA new elastic tourniquet cuff provided a more proper bloodless surgical field with less adjustment of tourniquet pressure despite a similar level of tourniquet pressure compared to the conventional cuff and had a low incidence of skin complications on the site of tourniquet application in TKA. These benefits make it an effective and safe medical device for orthopedic surgery requiring a tourniquet, such as TKA.

show abstract

Section: Discussioncontrasting

confidence: 49%

Section: Discussionmentioning

confidence: 64%

Section: Discussionmentioning

confidence: 95%

See 1 more Smart Citation

Efficacy and safety of a new elastic tourniquet cuff in total knee arthroplasty: a prospective randomized controlled study

Lee

2017

BioMed Eng OnLine

View full text Add to dashboard Cite

show abstract

“…This includes increased wound complications, impaired knee-extension strength, slower rehabilitation, prolonged hospitalization, and even the potential risk of mortality and morbidity [2][3][4]. Many strategies have been investigated in attempt to manage complications, which include minimally invasive procedures, without intraoperative tourniquet utilization, intra-articular injection of tranexamic acid and/or corticosteroid, cryotherapy, immobilization, compression bandage technique, and elevation of the affected limb [5][6][7][8].…”

Section: Introductionmentioning

confidence: 99%

Should compression bandage be performed after total knee arthroplasty? A meta-analysis of randomized controlled trials

Liu

Zhang

et al. 2020

J Orthop Surg Res

View full text Add to dashboard Cite

Background: Compression bandage often is used after total knee arthroplasty (TKA) to alleviate pain, ameliorate swelling, and reduce bleeding. However, there is controversy about its application due to conflicting clinical outcomes and potential compression-related complications. This meta-analysis aimed to answer the question of if compression bandage should be implemented routinely after TKA. Methods: Relevant randomized controlled trials (RCTs) on compression bandage were comprehensively retrieved utilizing search engines such as PubMed, EMBASE, Web of Science, and the Cochrane Library, up to September 2019. Studies included in the meta-analysis were those that compared post-operative pain score, swelling, total blood loss, pre-and post-operative hematocrit levels differences, range of motion (ROM), and complications, using Review Manager 5.3.0. Results: Included were seven RCTs, which reported on 511 knees. The pooled results showed the compression bandage group was associated with a greater post-operative pain score during ambulation at 48 h (WMD = 0.70, 95% CI 0.07 to 1.34, P = 0.03), compared with the non-compression bandage group. No statistically significant differences were found between the groups in post-operative pain scores at the other times, swelling, blood loss, ROM, or other complications (P > 0.05). Conclusions: The current evidence is unable to conclude that compression bandage is necessary after primary TKA. Surgeons routinely undertaking compression bandage should deliberate whether there is enough clinical evidence.

show abstract

“…Since most surgeons use tourniquet to facilitate the procedure mainly, there are no need for prolonged use of tourniquet. Various timings of deflation have been proposed in the literature, such as deflating tourniquet after cementing the implants [18][19][20], after closure of arthrotomy [21], or immediately after wound closure [22]. However, no consensus has been achieved to date.…”

Section: Introductionmentioning

confidence: 99%

Tourniquet Use in Total Knee Arthroplasty

Hsu¹,

Chang²,

Yang³

et al. 2018

Primary Total Knee Arthroplasty

View full text Add to dashboard Cite

The use of an intraoperative tourniquet for total knee arthroplasty (TKA) is a common practice. Although it provides clear filed and ideal cementation during surgery, issues regarding the effectiveness, drawbacks and complications are still investigated. This review was conducted to evaluate the role of tourniquet in TKA through a comprehensive literature search was done in PubMed Medicine, Embase, and other internet database. Debating issues, including the blood loss, operation time, alignment, compromised wound healing, quadriceps weakness and timing of release were furtherly examined. Based on our prior work and the general consensus that the tourniquet should be set with the lowest pressure and for the least ischemic time possible, we recommend early tourniquet release right after the closure of extensor mechanism in the TKAs without drainage.

show abstract

Tourniquet Release Prior to Dressing Application Reduces Blistering Following Total Knee Arthroplasty

Cited by 20 publications

References 17 publications

Efficacy and safety of a new elastic tourniquet cuff in total knee arthroplasty: a prospective randomized controlled study

Efficacy and safety of a new elastic tourniquet cuff in total knee arthroplasty: a prospective randomized controlled study

Should compression bandage be performed after total knee arthroplasty? A meta-analysis of randomized controlled trials

Tourniquet Use in Total Knee Arthroplasty

Contact Info

Product

Resources

About