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首页> 外文期刊>The Journal of foot and ankle surgery: official publication of the American College of Foot and Ankle Surgeons >Survey of tourniquet use in podiatric surgery.
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Survey of tourniquet use in podiatric surgery.

机译：足底外科手术中止血带使用情况的调查。

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Tourniquet use in foot and ankle surgery is common practice; however, the technique varies among foot and ankle surgeons and there are no standard guidelines. To analyze trends in foot and ankle tourniquet use, the authors conducted an e-mail survey. One thousand six hundred sixty-five foot and ankle surgeons were sent a tourniquet-use survey via e-mail, across Canada and the United States. Nineteen percent of the recipients completed and returned the surveys. Eleven (3.4%) rarely or never use a tourniquet and 8 (2.5%) use an Esmarch bandage tourniquet at the ankle. Most use pneumatic ankle cuffs (92% use, 27% use exclusively); many also use thigh cuffs (69%) and some also use calf cuffs (15%). Most thigh-cuff users (62%) experience problems with cuff fit sometimes or often. All but 3 respondents exsanguinate the limb before tourniquet inflation. Specific devices used for exsanguination varied among surgeons. Most commonly used tourniquet pressures range from /=351 mm Hg for the thigh (64% use pressures between 301 and 350 mm Hg). Only 7% of respondents consider limb occlusion pressure when selecting tourniquet cuff pressure. Based on published studies of limb occlusion pressures, these ranges suggest that some of the more common pressure settings may be higher than necessary for many patients. Vascular disease or previous bypass (91%) and deep vein thrombosis (83%) were the most commonly listed contraindications to tourniquet use. Approximately 10% of respondents have either experienced or learned of skin and nerve injuries secondary to lower extremity tourniquet use at any level. The varied responses show a lack of overall consensus on tourniquet pressure settings. Guidelines for optimizing cuff pressure and technique should be established to minimize the risk of complications. (The Journal of Foot & Ankle Surgery 42(2):68-76, 2003)
机译：在足踝手术中使用止血带是很常见的做法。但是，该技术因脚和脚踝外科医生而异，并且没有标准指南。为了分析足踝止血带的使用趋势，作者进行了电子邮件调查。在加拿大和美国，通过电子邮件向165个脚踝外科医师发送了止血带使用情况调查表。 19％的收件人完成并返回了调查。 11个（3.4％）很少或从不使用止血带，而8（2.5％）个在脚踝处使用Esmarch绷带止血带。大多数使用气动脚腕套（92％使用，27％仅使用）;许多人也使用大腿袖口（69％），而一些人也使用小腿袖口（15％）。大多数大腿袖带使用者（62％）有时或经常遇到袖带合身问题。除3名受访者外，其余所有人在止血带充血前将肢体抽血。用于放血的特定设备因外科医生而异。最常用的止血带压力在脚踝处为 / = 351 mm Hg（64％的使用压力在301至350 mm Hg之间）。选择止血带袖带压力时，只有7％的受访者考虑四肢闭塞压力。根据已发表的肢体阻塞压力研究，这些范围表明，一些较常见的压力设置可能比许多患者所需的压力设置更高。血管疾病或先前的搭桥手术（91％）和深静脉血栓形成（83％）是止血带使用的最常见禁忌症。大约10％的受访者在任何水平下都曾因使用下肢止血带而遭受皮肤和神经损伤的经验或了解。各种各样的回答表明在止血带压力设置上缺乏总体共识。应建立优化袖带压力和技术的指南，以最大程度降低并发症风险。 （《足踝外科杂志》 42（2）：68-76，2003）

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