Tham khảo tài liệu 'chấn thương thiếu máu cục bộ', y tế - sức khoẻ, y học thường thức phục vụ nhu cầu học tập, nghiên cứu và làm việc hiệu quả | Pneumatic Tourniquets in Extremity Surgery Abel Wakai MB Desmond C. Winter MD John T. Street MB and Paul H. Redmond MCh Abstract Pneumatic tourniquets maintain a relatively bloodless field during extremity surgery minimize blood loss aid identification of vital structures and expedite the procedure. However they may induce an ischemia-reperfusion injury with potentially harmful local and systemic consequences. Modern pneumatic tourniquets are designed with mechanisms to regulate and maintain pressure. Routine maintenance helps ensure that these systems are working properly. The complications of tourniquet use include postoperative swelling delay of recovery of muscle power compression neurapraxia wound hematoma with the potential for infection vascular injury tissue necrosis and compartment syndrome. Systemic complications can also occur. The incidence of complications can be minimized by use of wider tourniquets careful preoperative patient evaluation and adherence to accepted principles of tourniquet use. J Am Acad Orthop Surg 2001 9 345-351 The pneumatic tourniquet was introduced in 1904 by Harvey Cushing to maintain a bloodless field during extremity surgery. Since then its use has become almost routine and the widespread assumption that maintaining a bloodless field is of prime importance leads many surgeons to lose sight of the potentially dangerous nature of this piece of Modern pneumatic tourniquets are designed to minimize the incidence of complications and prospective randomized clinical trials have shown no significant long-term deleterious effects of using them in extremity 3 Nevertheless their use is still associated with potentially serious morbidity4-8 and even Therefore it is important for orthopaedic surgeons to be knowledgeable about the pathophysiology of tourniquet-induced skeletal-muscle ischemia-reperfusion injury and the potential pitfalls of using pneumatic tourniquets. Advances in molecular biology are .
