title: Tourniquet Release Prior to Dressing Application Reduces Blistering Following Total Knee Arthroplasty.
abstract: Skin blisters occur in up to 20% of patients after total knee arthroplasty (TKA). Tourniquet release results in a limb volume increase of 10%. We hypothesized that releasing tourniquet before application of circumferential dressing will decrease blister formation. A prospective study was conducted on 135 consecutive primary TKAs. The tourniquet was released immediately after wound closure to allow for re-perfusion and then a dressing was applied. These patients were compared to a historical cohort of 200 primary TKAs, where the tourniquet was released after application of dressing. There was a significant difference in the incidence of blisters between the two groups [Late 7.5% (15/200) vs early release 2.2% (3/135) P=0.028]. Releasing the tourniquet prior to dressing application has reduced the incidence of blistering following TKA.
authors.affiliation: Investigation performed at The Rothman Institute at Thomas Jefferson University Hospital, Philadelphia, Pennsylvania.
authors.forename: Snir
authors.initials: S
authors.lastname: Heller
authors.affiliation: Investigation performed at The Rothman Institute at Thomas Jefferson University Hospital, Philadelphia, Pennsylvania.
authors.forename: Antonia
authors.initials: A
authors.lastname: Chen
authors.affiliation: Investigation performed at The Rothman Institute at Thomas Jefferson University Hospital, Philadelphia, Pennsylvania.
authors.forename: Camilo
authors.initials: C
authors.lastname: Restrepo
authors.affiliation: Investigation performed at The Rothman Institute at Thomas Jefferson University Hospital, Philadelphia, Pennsylvania.
authors.forename: Emily
authors.initials: E
authors.lastname: Albert
authors.affiliation: Investigation performed at The Rothman Institute at Thomas Jefferson University Hospital, Philadelphia, Pennsylvania.
authors.forename: William J
authors.initials: WJ
authors.lastname: Hozack
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D019645:Arthroplasty, Replacement, Knee / Q000379:methods*; D001458:Bandages; D001768:Blister / Q000209:etiology / Q000517:prevention & control*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000209:etiology / Q000517:prevention & control*; D011446:Prospective Studies; D014111:Tourniquets / Q000009:adverse effects*
keywords: blisters; blood loss; complications; knee arthroplasty; tourniquet