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.
Orthopaedic Research Unit, University of Cambridge, Addenbrooke's Hospital, Cambridge, England, UK.
M T
MT
Clarke
L
L
Longstaff
D
D
Edwards
N
N
Rushton
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*