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Local hypothermia to prolong safe tourniquet time.
A B Swanson1, L C Livengood, A B Sattel
1Blodgett Memorial Medical Center, Grand Rapids, Michigan 49506.
Clinical Orthopaedics and Related Research
|March 1, 1991
Summary
Local hypothermia safely extends tourniquet time for upper extremity reconstructive surgery. This method reduces risks associated with prolonged ischemia, allowing for longer procedures.
Area of Science:
- Orthopedic Surgery
- Vascular Surgery
- Trauma Surgery
Background:
- Prolonged tourniquet application is limited by ischemia.
- Reconstructive procedures of the upper extremity often require extended tourniquet times.
Purpose of the Study:
- To evaluate the safety and efficacy of local hypothermia in extending tourniquet time for upper extremity reconstructive surgery.
Main Methods:
- An ice blanket (flannel cloth and cold gel packs) was applied to the limb for 45 minutes preoperatively.
- Seventy-eight patients undergoing reconstructive surgery were evaluated.
- Muscle temperature and postoperative complications were monitored.
Main Results:
- Preoperative cooling reduced limb temperature by an average of 12.9 degrees Celsius.
- Average tourniquet time was 2 hours and 25 minutes.
- No ischemic changes were observed on electron microscopy, and no complications arose.
Conclusions:
- Local hypothermia is a safe and effective adjunct to prolong tourniquet time.
- This technique mitigates adverse effects of ischemia, enabling longer surgical interventions.
- It allows safe extension of tourniquet inflation beyond the standard two-hour limit.