Wrist tourniquet: The most patient-friendly way of bloodless hand surgery

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dc.contributor.authorKaralezli, Nazim
dc.contributor.authorOgun, Cemile Oztin
dc.contributor.authorOgun, Tunc Cevat
dc.contributor.authorYidirim, Serhat
dc.contributor.authorTuncay, Ibrahim
dc.date.accessioned2020-03-26T17:18:47Z
dc.date.available2020-03-26T17:18:47Z
dc.date.issued2007
dc.departmentSelçuk Üniversitesien_US
dc.description.abstractBackground: The literature is scarce on wrist tourniquets. In this study, three well-established locations of tourniquet setting including upper arm, proximal forearm, and wrist were compared on the same limb using both clinical as well as biochemical variables in paramedical volunteers. Methods. Twenty unmedicated, healthy, paramedical, right-hand dominant volunteers participated in the study. The left upper arms were used for monitoring. Blood pressures and heart rates were monitored and recorded before (baseline) and immediately after the application of the tourniquet, every 5 minutes, and at the time the patient requested deflation. An intravenous cannula (22 G) was placed on the right hand to obtain samples, which were taken at baseline and immediately after deflation of the tourniquet to evaluate the levels of pO(2), pCO(2) O-2 saturation, pH, bicarbonate, blood sugar, lactate, hematocrit, and electrolytes. The tourniquets were applied to the right upper arm, forearm, and wrist of each subject with 5-day intervals between each trial. Subjective discomfort and tourniquet pain levels were recorded. For each trial, tourniquet tolerance and details of discomfort were recorded. Statistical analysis was performed as appropriate. Results: Twenty volunteers aged 20 to 44 years were included. For each trial, in the first 10 minutes after inflation of the tourniquet, the heart rate and systolic blood pressure were increased compared with baseline values. Diastolic blood pressure was elevated immediately after inflation and remained so until deflation in each trial. Diastolic blood pressure values were higher in the upper-arm tourniquet group compared with wrist. Then pH, pO(2), and O-2. saturation values were de-creased and pCO(2) and lactate levels were increased compared with baseline values in each trial. Blood sugar was decreased significantly in the arm group. The decrease in pH, pO(2), O-2 saturation, and blood sugar in the upper arm group was significantly higher compared with wrist and forearm groups. The lactate value was higher in the upper arm group compared with wrist. Visual analog scale and numerical rating scores were lower in the wrist group compared with others at all times. The longest tourniquet tolerance was in the wrist group. In the wrist group, curling was observed in all subjects but the fingers could easily be extended. Conclusion: The wrist tourniquet is the most comfortable technique of bloodless surgery for procedures limited to the hand region.en_US
dc.identifier.doi10.1097/01.ta.0000249076.11239.96en_US
dc.identifier.endpage754en_US
dc.identifier.issn0022-5282en_US
dc.identifier.issn1529-8809en_US
dc.identifier.issue3en_US
dc.identifier.pmid17414359en_US
dc.identifier.scopusqualityN/Aen_US
dc.identifier.startpage750en_US
dc.identifier.urihttps://dx.doi.org/10.1097/01.ta.0000249076.11239.96
dc.identifier.urihttps://hdl.handle.net/20.500.12395/21737
dc.identifier.volume62en_US
dc.identifier.wosWOS:000244877300039en_US
dc.identifier.wosqualityQ1en_US
dc.indekslendigikaynakWeb of Scienceen_US
dc.indekslendigikaynakScopusen_US
dc.indekslendigikaynakPubMeden_US
dc.language.isoenen_US
dc.publisherLIPPINCOTT WILLIAMS & WILKINSen_US
dc.relation.ispartofJOURNAL OF TRAUMA-INJURY INFECTION AND CRITICAL CAREen_US
dc.relation.publicationcategoryMakale - Uluslararası Hakemli Dergi - Kurum Öğretim Elemanıen_US
dc.rightsinfo:eu-repo/semantics/closedAccessen_US
dc.selcuk20240510_oaigen_US
dc.subjecttourniqueten_US
dc.subjecthand surgeryen_US
dc.titleWrist tourniquet: The most patient-friendly way of bloodless hand surgeryen_US
dc.typeArticleen_US

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