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Tourniquet Use in Extremity-Based Microsurgery.

John Corbett1,2, Madeline Rocks3, Meagan Wu4

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

Journal of Reconstructive Microsurgery
|July 19, 2023
PubMed
Summary
This summary is machine-generated.

Tourniquets can be safely used in extremity microsurgery to improve visualization and enable bloodless dissection. This study found no increased complication rates associated with tourniquet use during flap elevation, vessel harvest, or anastomosis.

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Area of Science:

  • Microsurgery
  • Vascular Surgery
  • Orthopedic Surgery

Background:

  • Tourniquet use in extremity microsurgery remains under-investigated.
  • Limited data exists on associated outcomes and complications.
  • Hypothesis: Tourniquets enhance surgical field visualization and enable bloodless dissection without increased complications.

Purpose of the Study:

  • To investigate the use and outcomes of tourniquets in extremity-based microsurgery.
  • To assess the complication rates associated with tourniquet application during specific surgical phases.

Main Methods:

  • Retrospective chart review of 99 patients (106 surgeries) from January 2018 to February 2022.
  • Analysis of tourniquet use during flap elevation, vessel harvest, and microvascular anastomosis.
  • Statistical comparison of complication rates between tourniquet use and non-use within operative segments.

Main Results:

  • Tourniquets were used in 70% (flap elevation), 61% (vessel harvest), and 32% (anastomosis) of procedures.
  • No statistically significant difference in complication rates was found between cases with and without tourniquet use.
  • The most common complication was the need for an additional unplanned surgery (16%).

Conclusions:

  • Tourniquets are a viable tool for extremity microsurgery, facilitating bloodless dissection.
  • Their use does not appear to increase the risk of surgical complications.
  • Supports the hypothesis that tourniquets can be safely employed in these procedures.