Use Of Pneumatic Tourniquet Research Articles

Is a tourniquet really necessary for knee replacement?

The Journal of Bone and Joint Surgery. British volumeVol. 77-B, No. 2 ArticlesFree AccessIs a tourniquet really necessary for knee replacement?L KlenermanL KlenermanSearch for more papers by this authorPublished Online:1 Mar 1995https://doi.org/10.1302/0301-620X.77B2.7706327AboutSectionsPDF/EPUB ToolsAdd to FavouritesDownload CitationsTrack CitationsPermissions ShareShare onFacebookTwitterLinked InRedditEmail FiguresReferencesRelatedDetailsCited ByThe mid-term and long-term effects of tourniquet use in total knee arthroplasty: systematic review12 May 2022 | Journal of Experimental Orthopaedics, Vol. 9, No. 1Using Suction in Back-Bleeding Conditions Increases Cement Penetration without the Need for a TourniquetMedical Engineering & Physics, Vol. 55Anterior cruciate ligament reconstruction without the use of a tourniquetThe Annals of The Royal College of Surgeons of England, Vol. 101, No. 2Short term outcomes of long duration versus short duration tourniquet in primary total knee arthroplasty: A randomized controlled trialJournal of Clinical Orthopaedics and Trauma, Vol. 9, No. 1Timing of tourniquet release in total knee arthroplastyMedicine, Vol. 96, No. 17Tourniquet during total knee arthroplasty: A reviewApollo Medicine, Vol. 14, No. 1Use of a pneumatic tourniquet in total knee arthroplasty increases the risk of distal deep vein thrombosis: A prospective, randomized studyThe Knee, Vol. 23, No. 5Tranexamic Acid Decreases Incidence of Blood Transfusion in Simultaneous Bilateral Total Knee ArthroplastyThe Journal of Arthroplasty, Vol. 30, No. 12Tourniquet use during total knee arthroplasty does not offer significant benefit: A retrospective cohort studyInternational Journal of Surgery, Vol. 18The efficacy of tourniquet assisted total knee arthroplasty on patient-reported and performance-based physical function: a randomized controlled trial protocol29 March 2014 | BMC Musculoskeletal Disorders, Vol. 15, No. 1The effects of a tourniquet used in total knee arthroplasty: a meta-analysis6 March 2014 | Journal of Orthopaedic Surgery and Research, Vol. 9, No. 1The use of pneumatic tourniquet in total knee arthroplasty: a meta-analysis17 August 2014 | Archives of Orthopaedic and Trauma Surgery, Vol. 134, No. 10The effect of tourniquet use in total knee arthroplasty: grading the evidence through an updated meta-analysis of randomized, controlled trials11 July 2013 | European Journal of Orthopaedic Surgery & Traumatology, Vol. 24, No. 6Faster recovery without the use of a tourniquet in total knee arthroplasty23 June 2014 | Acta Orthopaedica, Vol. 85, No. 4Late Tourniquet Release and Drain Clamping Reduces Postoperative Blood Loss in Total Knee Arthroplasty1 October 2013 | HSS Journal ®, Vol. 10, No. 1Risk and Benefits of Bilateral Total Knee Replacement Surgery4 June 2014The use of pneumatic tourniquets is safe in Asians undergoing total knee arthroplasty without anticoagulationThe Knee, Vol. 21, No. 1RETRACTED ARTICLE: Meta-analysis on the efficacy of tourniquet on ankle trauma surgery10 December 2013 | European Journal of Medical Research, Vol. 18, No. 1The efficacy of the tourniquet in foot and ankle surgery? A systematic review and meta-analysisFoot and Ankle Surgery, Vol. 16, No. 1Is a tourniquet beneficial in total knee replacement surgery?The Knee, Vol. 17, No. 2Case series and literature review: Popliteal artery injury following total knee replacementInternational Journal of Surgery, Vol. 8, No. 6A meta-analysis of tourniquet assisted arthroscopic knee surgeryThe Knee, Vol. 16, No. 5Strategies for blood management in orthopaedic and trauma surgeryR. Lemaire1 September 2008 | The Journal of Bone and Joint Surgery. British volume, Vol. 90-B, No. 9Effect of tourniquet application on deep vein thrombosis after total knee arthroplasty11 November 2006 | Archives of Orthopaedic and Trauma Surgery, Vol. 127, No. 8Trombose arterial relacionada à artroplastia total de joelho: revisão de literaturaActa Ortopédica Brasileira, Vol. 13, No. 4Pneumatic Tourniquets in Extremity SurgeryJournal of the American Academy of Orthopaedic Surgeons, Vol. 9, No. 5Arterial Complications and Total Knee ArthroplastyJournal of the American Academy of Orthopaedic Surgeons, Vol. 9, No. 4Nursing care of total joint replacementJournal of Orthopaedic Nursing, Vol. 4, No. 1Vascular injuries in total knee arthroplastyThe Journal of Arthroplasty, Vol. 13, No. 2The Use of Cold Compression Dressings After Total Knee Replacement: A Randomized Controlled TrialOrthopedics, Vol. 21, No. 1Effect of tourniquet use on blood loss and incidence of deep vein thrombosis in total knee arthroplastyThe Journal of Arthroplasty, Vol. 12, No. 3Le garrot pneumatique d'orthopédieAnnales Françaises d'Anesthésie et de Réanimation, Vol. 15, No. 2 Vol. 77-B, No. 2 Metrics Downloaded 97 times History Published online 1 March 1995 Published in print 1 March 1995 InformationCopyright © 1995, The British Editorial Society of Bone and Joint Surgery: All rights reservedPDF download

An animal model for the study of neuromuscular injury induced beneath and distal to a pneumatic tourniquet

A well-controlled animal model is presented for the study of neuromuscular injury induced by a pneumatic tourniquet. This model comprises a curved tourniquet surrounded by a stiff exterior shell, both of which were specifically designed to fit the conical and oblong shape of the rabbit hindlimb. Computed tomographic imaging was used to assess transverse tissue displacement induced by tourniquet compression. The curved tourniquet/shell configuration occluded the distal arterial blood flow to the extremity at a significantly lower cuff inflation pressure than a straight tourniquet of equal width. The magnitude and distribution of tissue pressures in the subcutaneous and deep tissues beneath the tourniquet were similar to those recorded in previous human cadaver studies of tourniquet compression. This animal model will facilitate the quantitation and analysis of tissue injury induced beneath and distal to a pneumatic tourniquet. Such data can help define the critical pressure and time limits for the safe use of pneumatic tourniquets in extremity surgery.

Wide Tourniquets Eliminate Blood Flow at Low Inflation Pressures

Previous recommendations for use of pneumatic tourniquets in extremity surgery suggest parameters for maximum pressure and time limits without regard for optimum cuff width. Wide cuffs produce lower readings of blood pressure relative to narrow cuffs, presumably because the wide cuffs arrest flow at lower inflation pressure. We investigated three tourniquet sizes and the inflation pressure required to eliminate flow to the upper extremity using an ultrasonic Doppler device to monitor blood flow in the radial artery of ten normal subjects (arm circumference 24.5 to 37 cm). Arterial flow was always eliminated at the lowest pressure using the widest tourniquet cuff. Significantly lower inflation pressures will eliminate blood flow if wider tourniquet cuffs are used; therefore, use of a wider tourniquet cuff may result in a reduced incidence of tourniquet complications.

Wide tourniquets eliminate blood flow at low inflation pressures

Previous recommendations for use of pneumatic tourniquets in extremity surgery suggest parameters for maximum pressure and time limits without regard for optimum cuff width. Wide cuffs produce lower readings of blood pressure relative to narrow cuffs, presumably because the wide cuffs arrest flow at lower inflation pressure. We investigated three tourniquet sizes and the inflation pressure required to eliminate flow to the upper extremity using an ultrasonic Doppler device to monitor blood flow in the radial artery of ten normal subjects (arm circumference 24.5 to 37 cm). Arterial flow was always eliminated at the lowest pressure using the widest tourniquet cuff. Significantly lower inflation pressures will eliminate blood flow if wider tourniquet cuffs are used; therefore, use of a wider tourniquet cuff may result in a reduced incidence of tourniquet complications.

Tourniquet pressure: The effect of limb circumference and systolic blood pressure

Complications attributable to direct pressure may result from the use of pneumatic tourniquets during surgical procedures. Traditional estimates have determined the pressures employed rather than the minimal pressure necessary to produce a bloodless field. To determine this pressure, pre-operative and post-operative systolic blood pressures and the tourniquet pressure at which capillary bleeding occurred were measured in a group of patients undergoing elective surgery of the upper and lower limbs. From these results two equations were derived, one for each of the upper and lower limbs, which give the minimum tourniquet pressures to produce bloodless fields. In an average sized, normotensive patient, 200mm Hg was found to be adequate for the upper limb and 250mm Hg for the lower limb.

Tourniquet Pressure: The Effect of Limb Circumference and Systolic Blood Pressure

Complications attributable to direct pressure may result from the use of pneumatic tourniquets during surgical procedures. Traditional estimates have determined the pressures employed rather than the minimal pressure necessary to produce a bloodless field. To determine this pressure, pre-operative and post-operative systolic blood pressures and the tourniquet pressure at which capillary bleeding occurred were measured in a group of patients undergoing elective surgery of the upper and lower limbs. From these results two equations were derived, one for each of the upper and lower limbs, which give the minimum tourniquet pressures to produce bloodless fields. In an average sized, normotensive patient, 200mm Hg was found to be adequate for the upper limb and 250mm Hg for the lower limb.

Injury from use of pneumatic tourniquets.

Injury from use of pneumatic tourniquets.