title: The silicone ring tourniquet in orthopaedic operations of the extremities.
abstract: Tourniquets provide a bloodless field in limb operations and their introduction in orthopaedic operative technique has been considered as a landmark. A new tourniquet device, a silicone ring tourniquet (SRT) (HemaClear or S-MART, OHK Medical Devices, Haifa, Israel), was introduced into clinical practice a few years ago. A few clinical studies as well as comparative studies in volunteers have reported its use in a relatively small number of cases. The aim of this prospective study is to report the clinical use of this device in a large number of patients, including all possible applications of a tourniquet. The SRT was used in 536 cases including 337 male and 119 female patients with a mean age of 43.7 years (range 6 to 87 years). The average tourniquet time was 58.5 minutes (range 6 to 180 minutes). It was applied in 362 (67.5%) elective and in 174 (32.5%) trauma cases including fractures (n:109, 62.6%) and soft-tissue injuries (n:65, 37.4%). The most frequent application site was the femur (n:255, 47.6%), followed by the forearm (n:154, 28.7%), humerus (n:65, 12.1%), and calf (n:62, 11.6%). Because the device is sterile it was possible to use it in operations in which the pneumatic tourniquet cannot be used, such as open reduction and internal fixation of humeral shaft and femoral supracondylar fractures. In 14 patients (2.6%), the tourniquet failed intraoperatively, and the cause was an unexpected raised blood pressure. The SRT - with a pre-set pressure according to the size and the tension model - is easy to apply. It is sterile, and occupies a narrow area of the limb. Its application combines three functions at the same time: exsanguination, tourniquet, and stockinet application. Although it cannot entirely replace the classic pneumatic tourniquet, it is a safe and useful device in orthopaedic operations because of its advantages.
authors.affiliation: Department of Orthopaedic Surgery Medical School, Democritus University of Thrace University General Hospital of Alexandroupolis Alexandroupolis, Greece.
authors.forename: Georgios I
authors.initials: GI
authors.lastname: Drosos
authors.affiliation: Department of Orthopaedic Surgery Medical School, Democritus University of Thrace University General Hospital of Alexandroupolis Alexandroupolis, Greece.
authors.forename: Athanasios
authors.initials: A
authors.lastname: Ververidis
authors.affiliation: Department of Orthopaedic Surgery Medical School, Democritus University of Thrace University General Hospital of Alexandroupolis Alexandroupolis, Greece.
authors.forename: Rodion
authors.initials: R
authors.lastname: Mavropoulos
authors.affiliation: Research and Clinical Fellowship on Spine Loyola University Stritch School of Medicine Loyola University Medical Center Maywood, Illinois Musculoskeletal Biomechanics Laboratory Department of Veterans Affairs Edward Hines Jr. Veterans Affairs Hospital Hines, Illinois.
authors.forename: Georgios
authors.initials: G
authors.lastname: Vastardis
authors.affiliation: Athens Naval Hospital Athens, Greece.
authors.forename: Konstantinos I
authors.initials: KI
authors.lastname: Tsioros
authors.affiliation: Department of Orthopaedic Surgery Medical School, Democritus University of Thrace University General Hospital of Alexandroupolis Alexandroupolis, Greece.
authors.forename: Konstantinos
authors.initials: K
authors.lastname: Kazakos
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D016063:Blood Loss, Surgical / Q000517:prevention & control* / Q000706:statistics & numerical data*; D015984:Causality; D002648:Child; D015897:Comorbidity; D004867:Equipment Design; D019544:Equipment Failure Analysis; D005260:Female; D006115:Greece / Q000453:epidemiology; D006801:Humans; D007430:Intraoperative Care / Q000295:instrumentation / Q000706:statistics & numerical data; D008297:Male; D008875:Middle Aged; D009983:Orthopedic Equipment / Q000706:statistics & numerical data*; D019637:Orthopedic Procedures; D015995:Prevalence; D012307:Risk Factors; D012828:Silicones; D014111:Tourniquets / Q000706:statistics & numerical data*; D016896:Treatment Outcome; D055815:Young Adult
chemical_list: D012828:Silicones