Comparison of local pain and tissue reaction between conventional pneumatic tourniquet and disposable silicone ring tourniquet during Total Knee Arthroplasty.

Autor: Bhalchandra Londhe S; Consultant Orthopedic Surgeon, Criticare Hospital, Mumbai, India., Vinod Shah R; Consultant Orthopedic Surgeon, Criticare Hospital, India., Sanjay Londhe S; Computer Science Student, MIT College of Engineering, Pune, India., Agrawal PO; Consultant Orthopaedic Surgeon, Mehsana, Gujarat, India., Antao NA; Consultant Orthopaedic Surgeon, Holy Spirit Hospital, Mumbai, India., Churhe S; Orthopedic Resident Holy Spirit Hospital, Mumbai, India.
Jazyk: angličtina
Zdroj: Journal of clinical orthopaedics and trauma [J Clin Orthop Trauma] 2020 Sep 09; Vol. 15, pp. 152-155. Date of Electronic Publication: 2020 Sep 09 (Print Publication: 2021).
DOI: 10.1016/j.jcot.2020.09.005
Abstrakt: Background: To study the comparison of conventional pneumatic and disposable silicone ring tourniquet in Total Knee Arthroplasty.
Material and Methods: This is a prospective randomized control trial. We used conventional pneumatic tourniquet on one side of leg and disposable silicone ring tourniquet on the other side in consecutive 50 simultaneous bilateral TKR patients. Patients having peripheral vascular disease of the lower limb were excluded from the study. The patient demographics & characteristics are identical being the same patient with two different legs. We started the study with null hypothesis. An independent observer assessed the local tourniquet site pain (VAS score 1-10) and local tourniquet site skin reaction at 24 h and 48 h after the TKA. P value < 0.05 was considered significant.
Results: There were no local skin complication with disposable tourniquet (0%). 8 out of 50 patients in whom the conventional tourniquet was applied showed local bruising, and two patients had blister formation making the local skin site complication rate 20% (statistically significant, p value0.0196, chi-squared test). The VAS score at 24 h was 4.3 ± 1.5 for disposable tourniquet group as against 5.6 ± 2.1 for conventional tourniquet group (statistically significant, p value = 0.0152, t statistic test for comparison of means). The VAS score at 48 h was 2.1 ± 1.5 and 3.3 ± 1.2 for disposable tourniquet group and conventional tourniquet group respectively (statistically significant p value = 0.003, student's t-test).
Conclusion: Use of disposable tourniquet has better outcome than the conventional tourniquet with minimal or no local complications. The advantages of the disposable tourniquet are: 1 less local pain, 2. no local skin problems, 3. accurate tourniquet pressure at the application site, 4.0% local contamination. Hence, we recommend use of the disposable tourniquet during the Total Knee Arthroplasty.
Competing Interests: The author does not have any conflict of interest related to this work.
(© 2020 Delhi Orthopedic Association. All rights reserved.)
Databáze: MEDLINE
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