Tourniquet use in hand surgery – Is it time to re-inflate the evidence?

Gallagher, Michael J.; McKean, Andrew; McArthur, Gordon J.

doi:10.1016/j.bjps.2019.11.056

Cited by 3 publications

(3 citation statements)

References 6 publications

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Section: Intraoperative Management Of Hand Fracturesmentioning

confidence: 99%

“…A tourniquet is applied to reduce blood loss during surgery and keep the surgical field clear (Gallagher et al 2020). The upper limb is exsanguinated distally to proximally, and the tourniquet is inflated up to 250 mmHg for a maximum of two hours (BSSH 2021, Gallagher et al 2020). Prolonged use of a tourniquet and/or excessive pressure may result in peripheral nerve injury and tissue necrosis (Sharma & Salhotra 2012).…”

Section: Intraoperative Management Of Hand Fracturesmentioning

confidence: 99%

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Principles of management of hand fractures

Christodoulou

Asimakopoulos

Kapetanos

et al. 2022

Journal of Perioperative Practice

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The optimal management of hand fractures requires a multidisciplinary approach. Initial assessment should include a thorough medical history and clinical examination, followed by appropriate radiological imaging. These are crucial in determining the appropriate management. Following joint stabilisation to allow fractures to unite, early mobilisation is needed to maximise the functional restoration of the hand. In this review, the principles of operative and non-operative management of these injuries are discussed.

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Section: Intraoperative Management Of Hand Fracturesmentioning

confidence: 99%

Section: Intraoperative Management Of Hand Fracturesmentioning

confidence: 99%

Principles of management of hand fractures

Christodoulou

Asimakopoulos

Kapetanos

et al. 2022

Journal of Perioperative Practice

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“…Additional training is required for all medical personnel participating in the PTs application to improve patient treatment experiences, surgical outcomes, and promote safe perioperative care [ 7 – 9 ]. At the same time, the risks of PTs usage, indications, and contraindications are still discussed, and evidence is based mostly on small studies or case reports [ 10 ], which requires caution in approaching training programs and individual education. An in-depth examination of orthopedic operating room personnel’s knowledge, attitudes, and practices concerning PTs usage, thus, remains necessary.…”

Section: Introductionmentioning

confidence: 99%

Knowledge, attitudes, and practices of orthopedic operating room personnel regarding the use of pneumatic tourniquets

Zu,

Zhang,

Chen

et al. 2024

PLoS ONE

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Introduction Pneumatic tourniquets (PTs) play a crucial role in hemostasis during orthopedic surgery. This study aimed to investigate the current knowledge, attitudes, and practices (KAP) of orthopedic operating room personnel concerning the use of PTs. Methods This cross-sectional study was conducted from Jul. 2023 to Aug. 2023. An online questionnaire was used to collect demographic information and KAP score data of the orthopedic operating room personnel from Hangzhou Regional Hospitals. Results A total of 336 participants included orthopedic physicians (37.8%), orthopedic nurses (31.5%), anesthesiologists (8.9%), operating room nurses (19.9%) and medical students (1.8%). The median knowledge score was 28.5 (24, 32), with a maximum score of 38; the median attitude score was 31 (28, 35), of a maximum of 35; the median practice score was 41 (36, 44), of a maximum of 45. Correlation analysis showed links between knowledge and attitude (r = 0.388, p<0.001), knowledge and practice (r = 0.401, p<0.001), and attitude and practice (r = 0.485, p<0.001). Multivariate logistic regression analysis confirmed that female gender (OR = 0.294, 95% CI: 0.167–0.520; p<0.001), working in a specialized hospital (OR = 0.420, 95% CI: 0.219–0.803; p = 0.009), and occupation as a surgical anesthesiologist (OR = 3.358, 95% CI: 1.466–7.694; p = 0.004) were associated with better knowledge scores. A higher educational degree (OR = 0.237, 95% CI: 0.093–0.608; p = 0.003) was associated with better practice scores. No previous training was associated with lower knowledge (OR = 0.312, 95% CI: 0.187–0.520; p<0.001) and practice (OR = 0.325, 95% CI: 0.203–0.521; p<0.001) scores. Conclusion Orthopedic personnel in this study had acceptable knowledge, attitude, and practice concerning the use of PTs; additional training and guidance might enhance proficiency.

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