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Microvascular surgery in a bloodless field.

G A Dumanian1, A Chen

  • 1Division of Plastic Surgery, Northwestern University, Chicago, IL, USA. gdumania@nmh.org

Microsurgery
|October 4, 2000
PubMed
Summary

Tourniquet use in microsurgery speeds blood clotting distally. Despite elevated anticoagulants, microvascular surgery in a bloodless field is safe and effective for extremity procedures.

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Area of Science:

  • Vascular Surgery
  • Coagulation Science
  • Microsurgery

Background:

  • Tourniquets are crucial in extremity surgery.
  • Lack of clear guidelines for tourniquet use in microsurgery.

Purpose of the Study:

  • Investigate coagulation properties of blood distal to tourniquets.
  • Assess safety and efficacy of tourniquet use in microsurgery.

Main Methods:

  • Study involving 12 healthy volunteers.
  • Blood sampling distal to tourniquet and control arm.
  • Coagulation time, Fibrinopeptide A (FPA), tissue plasminogen activator (tPA), and Tissue Factor Pathway Inhibitor (TFPI) analysis.

Main Results:

  • Blood distal to tourniquet clotted significantly faster (12.5s vs 17.5s).
  • No significant difference in FPA or tPA levels.
  • Slight but significant elevation in TFPI in tourniquet blood.

Conclusions:

  • Microvascular surgery in a bloodless field is safe and effective.
  • Case series of 9 patients undergoing successful microvascular surgery with tourniquets.

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