title: [Effect of removing the ischaemia tourniquet on the transfusion needs of the patient undergoing primary knee arthroplasty].
abstract: OBJECTIVE
  To determine the influence of the timing of the removal of the ischaemia tourniquet on the transfusion needs in primary knee arthroplasty and its influence on post-operative complications.
  
  
  METHODS
  A retrospective analysis was performed on 201 primary knee arthroplasties. The patients were divided into 2 groups: group A (101 patients), where the tourniquet was removed before surgical closure, and group B (100 patients), where the tourniquet was removed after the surgical closure. A comparison was made of the blood transfusions (pools of red corpuscles) received by both groups, along with the surgical time, and the post-operative complications.
  
  
  RESULTS
  The mean number of packed red cells transfused in group A was 0.62, while in the group B it was 0.61 (P=.831). The mean time in the surgery in group A was 111 min, and in group B it was 98 min (P<.05), with no significant difference between the surgical time and the number of packed cells transfused (P=.055). The post-operative complications in the group A were 8, and in the B were 10 (P=.79).
  
  
  CONCLUSIONS
  There were no differences between removing the tourniquet before or after surgical closure or in the transfusion needs or in the post-operative complications. Traditionally, the greater blood loss due to the removal of the tourniquet before surgical closure has been explained as due to the longer surgery time required. However, in the present study, this fact was not associated with greater transfusion needs, or with more post-operative complications.
authors.affiliation: Servicio de Cirugía Ortopédica y Traumatología, Complexo Hospitalario Universitario de Ourense, Ourense, España. Electronic address: xavinef@gmail.com.
authors.forename: X
authors.initials: X
authors.lastname: Paredes-Carnero
authors.affiliation: Servicio de Anestesiología y Reanimación, Complexo Hospitalario Universitario de Ourense, Ourense, España.
authors.forename: G L
authors.initials: GL
authors.lastname: Rosero-Ruíz
authors.affiliation: Servicio de Anestesiología y Reanimación, Complexo Hospitalario Universitario de Ourense, Ourense, España.
authors.forename: J J
authors.initials: JJ
authors.lastname: Centeno-García
authors.affiliation: Servicio de Cirugía Ortopédica y Traumatología, Complexo Hospitalario Universitario de Ourense, Ourense, España.
authors.forename: F J
authors.initials: FJ
authors.lastname: Pombo-Taboada
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D019645:Arthroplasty, Replacement, Knee; D016063:Blood Loss, Surgical / Q000517:prevention & control*; D017707:Erythrocyte Transfusion / Q000706:statistics & numerical data*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007430:Intraoperative Care / Q000295:instrumentation / Q000379:methods*; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000453:epidemiology / Q000209:etiology / Q000517:prevention & control; D012189:Retrospective Studies; D013997:Time Factors; D014111:Tourniquets; D016896:Treatment Outcome
keywords: Arthroplasty; Artroplastia; Ischaemia; Isquemia; Knee; Rodilla; Transfusion; Transfusión