Ergebnisse einer Umfrage über die Anwendung der Blutleere und Blutsperre unter den Mitgliedern der DAF (Deutsche Assoziation für Fuß- und Sprunggelenk e.V) und Vergleich der Ergebnisse mit der aktuellen Literatur

Abstract

Introduction Which location, how long and which pressure are often discussed questions in the use of tourniquets. The aim of this study was the survey of the standards among the members of the DAF and comparison with current literature. Materials and Method The authors conducted an e-mail survey. 425 members of the DAF were asked to fill out a survey. The 27 questions concernd the type of tourniquet, location, pressure and complications. Additionally an analyses of the current literature was done. Results 87 responses (23%) were evaluated. The thigh was the most used location for application of a tourniquet. Most of the surgeons determined the cuff pressure based on the dimension of the leg or the blood pressure. The most commonly used pressure for thigh was 301 to 350 mmHg and for ankle 251 to 300 mmHg. In literature the limb occlusion pressure is the advised measure for determination of the cuff pressure. After 2 hours of operation about half of the responders open the tourniquet, another 1/3 of the surgeons tolerate 2 1/2 hours ischemia. The most surgeons experienced less than 5 complications (skin injuries, nerve injuries, deep vein thrombosis), secondary to lower extremity tourniquet use. Conclusion The results of this survey show that the application of a tourniquet is common. The used cuff pressures are often about 50 mmHg higher than the advised pressures in literature. But surgeons who use a higher cuff pressure do not experience more complications than other surgeons. If handled appropriate, the tourniquet is a safe tool.