Browsing by Subject "Tourniquet"

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    Open Access
    Intra-operative pneumatic tourniquet – perceptions of use and complications in the orthopaedic community of South Africa
    (1996) Gibson, A St Clair; Lambert, M I; Milligan, J; Merwe, W van der; Walters, J; Noakes, T D
    OBJECTIVES: To assess views on use, maintenance and side-effects of the pneumatic tourniquet in the South African orthopaedic community. METHODS: A census-type questionnaire study was conducted of all 475 orthopaedic surgeons registered with the Orthopaedic Association of South Africa during 1993/94. The chi-square test was used to determine statistical significance between different groups of respondents. RESULTS: Seventy-seven per cent of the questionnaires were returned. Ninety-nine per cent of respondents used a pneumatic tourniquet. Eighty-four per cent believed that the tourniquet may damage underlying tissue both as a result of applied pressure effects and ischaemic consequences. Fifty-four per cent of respondents personally checked the calibration of the pneumatic tourniquet, although 76% of respondents believe that the apparatus needs to be checked at least once per month. More respondents who did not check the tourniquet apparatus than respondents who did check it believe that applied pressure does not cause tissue damage (P < 0.001), that the operating room technician or hospital engineer should be responsible for checking equipment (P < 0.001), and that equipment did not need to be checked more than once every 6 months (P < 0.001). CONCLUSIONS: Although most orthopaedic surgeons are aware of the pneumatic tourniquet's side-effects, a minority appear to be unaware of the hazards of excessive applied pressure alone or excessive applied pressure caused by use of faulty equipment. It needs to be emphasised to these surgeons that regular checking of the pneumatic tourniquet apparatus is necessary in order to prevent postoperative complications ascribed to use of the tourniquet.
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    Open Access
    Use of a tourniquet in lower limb amputations: Evaluating blood loss in peripheral arterial disease patients A systematic review
    (2022) Eldurssi, Omar; Kloppers, Jacobus Christo
    Background: Tourniquets have become an inseparable part of many different types of intricate and major surgeries, including amputation. Tourniquets create a bloodless environment, which is thought to facilitate surgery and reduce time, potential errors and subsequent complications. Objectives: To investigate the effectiveness of using a pneumatic tourniquet as an adjunct in lower limbs amputation in peripheral arterial disease to reduce blood loss and requirement for blood transfusions. Stump revision rate, complication and mortality will be assessed as secondary objectives. Method: For this systematic review, a search was performed using the keywords phrases, “peripheral arterial disease”, “lower limb amputation” and “tourniquet” in PubMed, Medline, Embase and Google scholar. Results: Based on univariate analysis, to determine the relationship between risk factors and blood loss, the study demonstrated the use of tourniquet significantly reduces the amount of blood loss during lower limb amputation (LLA), F (21.01), P=0.044. An independent t -test, demonstrated that there was a statistically significant difference in mean blood loss between tourniquet and non-tourniquet studies, (T=-2.588, P=0.049). In this review the mean blood loss was 251.67±2.89 and 462.5±137.69ml for tourniquet and non-tourniquet studies respectively. Conclusion: Using a tourniquet is a technically feasible approach to LLA, and effectively reduces the amount of blood loss and requirements of blood transfusion. No change in revision rates were noted.