title: Does the method of expression of venous blood affect ischaemia/reperfusion damage in tourniquet use? An experimental study on rabbits.
abstract: The aim of this study was to compare the ischaemia and reperfusion phases of two tourniquet application models (Group 1: expressing the blood by a sterile rubber bandage and Group 2: elevation of the limb for several minutes) using an analysis of ischaemia/reperfusion parameters and blood pH. Sixteen New Zealand rabbits were used. Muscle samples were extracted from the triceps surae; at phase A (baseline: just before tourniquet application), phase B (ischaemia: 3h after tourniquet inflation) and phase C (2h after tourniquet deflation). Nitrite, nitrate, reduced glutathione, myeloperoxidase, malondyaldehyde were measured in the samples. Blood pH was also measured at each phase. Group 2 had significantly decreased nitrite (p=0.007) and nitrate (p=0.01) levels compared to Group 1 while passing from phase A to phase B. The pH decrease through the phases was significant within Group 1 (p=0.006) and was not significant within Group 2 (p=0.052). Lower levels of NO metabolites nitrate and nitrite, result from tourniquet use with incomplete venous blood expression by elevation. Also, with this technique severe acidosis is less likely to occur than when a tourniquet is used with expression of the venous blood by rubber bandage. These findings may help in the decision of which tourniquet technique is to be used for potentially long operations which may exceed 2h.
authors.affiliation: Ankara Training and Research Hospital, Department of Orthopaedics and Traumatology, Turkey.
authors.forename: Serkan
authors.initials: S
authors.lastname: Iltar
authors.forename: Cem Yalın
authors.initials: CY
authors.lastname: Kılınç
authors.forename: Kadir Bahadır
authors.initials: KB
authors.lastname: Alemdaroğlu
authors.forename: Selahattin
authors.initials: S
authors.lastname: Ozcan
authors.forename: Nevres Hürriyet
authors.initials: NH
authors.lastname: Aydoğan
authors.forename: Hatice
authors.initials: H
authors.lastname: Sürer
authors.forename: Aytün Şadan
authors.initials: AŞ
authors.lastname: Kılınç
mesh_terms: D000138:Acidosis / Q000473:pathology; D000818:Animals; D015415:Biomarkers / Q000097:blood; D007511:Ischemia / Q000473:pathology*; D008315:Malondialdehyde / Q000097:blood; D018482:Muscle, Skeletal / Q000473:pathology*; D009566:Nitrates / Q000097:blood; D009573:Nitrites / Q000097:blood; D019637:Orthopedic Procedures / Q000379:methods*; D009195:Peroxidase / Q000097:blood; D011817:Rabbits; D015427:Reperfusion Injury / Q000473:pathology*; D014111:Tourniquets
chemical_list: D015415:Biomarkers; D009566:Nitrates; D009573:Nitrites; D008315:Malondialdehyde; D009195:Peroxidase
keywords: Expression of venous blood; Ischaemia and reperfusion; Tourniquet