Techniques to maintain a bloodless field in lower extremity surgery.

Abstract

Most surgeons and podiatrists prefer to operate on toes and feet with a bloodless operating field. This can be achieved with a pneumatic tourniquet applied to the thigh after exsanguination of the limb with a rubber bandage or with an Esmark bandage alone, placed below the knee. A pneumatic tourniquet requires the use of general anesthesia with associated increased risks. The purpose of this study was to describe the differences in the complications in patients who have had foot surgery with either a thigh pneumatic tourniquet or a lower-leg Esmark bandage. 120 patients underwent foot surgery at a 350-bed tertiary care facility in Central Texas. A retrospective, descriptive study of the postoperative complications after foot surgery. Based on limb assessment in the operating room and in day surgery, there were no adverse effects at the site of placement of the Esmark or the pneumatic tourniquets or unexpected postoperative problems at the surgical site. No patient expressed any problems at the site of placement of the Esmark or the pneumatic tourniquet. A calf ankle Esmark with adequate padding is a safe and effective method to achieve a bloodless surgical field for foot and ankle surgery.