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Using the Boazul cuff to reduce blood loss in varicose vein surgery
J Robinson1, J Macierewicz, J D Beard
1Sheffield Vascular Institute, Northern General Hospital, Sheffield, UK.
Insights
The sterile exsanguination tourniquet (Boazul cuff) significantly reduces blood loss during varicose vein surgery. This device aids in minimizing bleeding from avulsion sites, even with an increased number of procedures.
Area of Science:
- Vascular Surgery
- Surgical Innovation
- Minimally Invasive Procedures
Background:
- Varicose vein surgery, including saphenofemoral disconnection and avulsions, can involve significant blood loss.
- Controlling intraoperative bleeding is crucial for patient safety and surgical outcomes.
Purpose of the Study:
- To evaluate the efficacy of a sterile exsanguination tourniquet (Boazul cuff) in reducing blood loss during varicose vein surgery.
- To assess the impact of the tourniquet on blood loss from both the groin and avulsion wounds.
Main Methods:
- Prospective, parallel cohort study involving 38 patients undergoing primary varicose vein surgery.
- Blood loss and the number of avulsion wounds were meticulously recorded for each patient.
- Comparison between a group using the Boazul cuff and a control group without the tourniquet.
Main Results:
- The tourniquet group (21 legs) showed significantly less blood loss from the leg (median 5 ml vs. 95 ml, p<0.0001).
- Despite a higher mean number of avulsions in the tourniquet group (25 vs. 15, p<0.001), blood loss was still reduced.
- Blood loss from the groin was comparable between groups (median 15 ml vs. 17.5 ml).
Conclusions:
- The Boazul cuff effectively decreases blood loss from avulsion sites in routine varicose vein surgery.
- The use of the tourniquet may facilitate a higher number of avulsions during the procedure.
- This sterile exsanguination tourniquet represents a valuable tool for improving surgical outcomes in varicose vein treatment.
Objective:
this study was designed to assess if the use of a sterile exsanguination tourniquet (Boazul cuff) reduced blood loss from the groin and avulsion wounds during varicose vein surgery, (saphenofemoral disconnection, stripping to knee and multiple avulsions).
Design:
prospective, parallel cohort study.
Materials:
thirty-eight patients undergoing primary varicose vein surgery.
Methods:
the blood loss and number of avulsion wounds were recorded for each patient.
Results:
the tourniquet was used on 21 legs and there were 24 legs in the non-tourniquet group. In the tourniquet group, the median blood loss from the groin was 15 ml, (range 5-70 ml), and from the leg was 5 ml, (range 0-120 ml). The corresponding figures for the group without the tourniquet were a median of 17.5 ml, (range 5-105 ml), and a median of 95 ml, (range 10-505 ml). The mean number of avulsions in the tourniquet group was 25 (range 9-38), and in the non-tourniquet group was 15, (range 5-40). There was significantly less blood loss from the leg in the tourniquet group (p<0.0001) despite the fact that there were more avulsions in the tourniquet group (p<0.001).
Conclusions:
use of the Boazul cuff significantly decreases the blood loss from the avulsion sites during routine varicose vein surgery, and may encourage the surgeon to perform more avulsions.