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Effect of Tourniquet Use During Surgical Treatment of Open Fractures
- Source :
- Journal of Bone and Joint Surgery. 103:860-868
- Publication Year :
- 2021
- Publisher :
- Ovid Technologies (Wolters Kluwer Health), 2021.
-
Abstract
- Background We sought to evaluate whether tourniquet use, with the resultant ischemia and reperfusion, during surgical treatment of an open lower-extremity fracture was associated with an increased risk of complications. Methods This is a retrospective cohort study of 1,351 patients who had an open lower-extremity fracture at or distal to the proximal aspect of the tibia and who participated in the FLOW (Fluid Lavage of Open Wounds) trial. The independent variable was intraoperative tourniquet use, and the primary outcome measures were adjudicated unplanned reoperation within 1 year of the injury and adjudicated nonoperative wound complications. Results Unplanned reoperation and nonoperative wound complications were roughly even between the no-tourniquet (18.7% and 19.1%, respectively) and tourniquet groups (17.8% and 20.8%) (p = 0.78 and p = 0.52). Following matching, as determined by model interactions, tourniquet use was a significant predictor of unplanned reoperation in Gustilo Type-IIIA (odds ratio, 3.60; 95% confidence interval, 1.16 to 11.78) and IIIB fractures (odds ratio, 16.61; 95% confidence interval, 2.15 to 355.40). Conclusions The present study showed that tourniquet use did not influence the likelihood of complications following surgical treatment of an open lower-extremity fracture. However, in cases of severe open fractures, tourniquet use was associated with increased odds of unplanned reoperation; surgeons should be cautious with regard to tourniquet use in this setting. Level of evidence Therapeutic Level III. See Instructions for Authors for a complete description of levels of evidence.
- Subjects :
- Adult
Male
medicine.medical_specialty
Bone healing
Odds
Fractures, Open
03 medical and health sciences
0302 clinical medicine
Fracture Fixation
Humans
Medicine
Orthopedics and Sports Medicine
030212 general & internal medicine
Tibia
Surgical treatment
Retrospective Studies
Fracture Healing
030222 orthopedics
Tourniquet
business.industry
Retrospective cohort study
General Medicine
Odds ratio
Middle Aged
Tourniquets
Confidence interval
Surgery
Tibial Fractures
surgical procedures, operative
Reperfusion Injury
Female
business
Leg Injuries
Subjects
Details
- ISSN :
- 15351386 and 00219355
- Volume :
- 103
- Database :
- OpenAIRE
- Journal :
- Journal of Bone and Joint Surgery
- Accession number :
- edsair.doi.dedup.....96c9ad7de2666541706c0550dccc9894