Tourniquet-induced wound hypoxia after total knee replacement.
We have investigated whether the thigh tourniquet used during total knee replacement (TKR) influenced the development of postoperative wound hypoxia and was a cause of delayed wound healing. We allocated randomly 31 patients (31 TKRs) to one of three groups: 1) no tourniquet; 2) tourniquet inflated at low pressure (about 225 mmHg); and 3) tourniquet inflated to high pressure of about 350 mmHg. Wound oxygenation was measured using transcutaneous oxygen electrodes. In the first week after surgery, patients with a tourniquet inflated to a high pressure had greater wound hypoxia than those with a low pressure. Those without a tourniquet also had wound hypoxia, but the degree and duration were less pronounced than in either of the groups with a tourniquet. Use of a tourniquet during TKR can increase postoperative wound hypoxia, especially when inflated to high pressures. Our findings may be relevant to wound healing and the development of wound infection.
Clarke
M T
MT
Orthopaedic Research Unit, University of Cambridge, Addenbrooke's Hospital, Cambridge, England, UK.
Longstaff
L
L
Edwards
D
D
Rushton
N
N
D019645:Arthroplasty, Replacement, Knee; D001785:Blood Gas Monitoring, Transcutaneous; D006801:Humans; D007866:Leg / Q000098:blood supply; D011183:Postoperative Complications / Q000503:physiopathology*; D012307:Risk Factors; D012867:Skin / Q000098:blood supply; D014111:Tourniquets; D014945:Wound Healing / Q000502:physiology*