Tourniquet release timing had no significant impact on results of upper extremity surgery
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Key takeaways:
- Tourniquet release timing had no significant differences in pain scores, patient satisfaction, QuickDASH scores or complications.
- Tourniquet release timing did not significantly impact surgical time.
SAN FRANCISCO — Tourniquet release timing did not significantly impact clinical outcomes in patients undergoing upper extremity surgery, according to results presented at the American Academy of Orthopaedic Surgeons Annual Meeting.
“Surgeons should feel confident using a case-by-case basis for what they see and what they like to do in their practice knowing that it will not impact their immediate postoperative or 2-week outcome data,” Warren A. Williams, MD, said in his presentation here.
Williams and colleagues randomly assigned 214 patients undergoing traumatic or elective upper extremity surgery who required the use of a tourniquet into two groups: one in which the tourniquet was released before closure (n=107) and one in which the tourniquet was released after (n=107) closure.
“Intraoperative data collection included all of these factors about the surgery itself, including the length of the incision and the time of the surgery,” Williams said. “Then the 2-week follow-up outcome data included our visual analog scales [and] our patient satisfaction rates. We did a QuickDASH outcome score for all of our patients, and then we looked for postoperative complications.”
Although 16% of patients who had the tourniquet released prior to closure needed significant electrocautery and time spent trying to attain hemostasis before closure, Williams said there was no significant difference in total surgical time. Tourniquet time was also longer in patients who had the tourniquet released after closure, but these patients did not have a significantly longer surgery time.
Williams added the two groups had no significant differences in pain scores, patient satisfaction, QuickDASH scores or postoperative complications at 2-week follow-up.
“We also saw that there was no significant difference when we did the same study but only used trauma and elective patients separately,” Williams said. “However, when you look at the trauma patients as a whole, they had better outcome data in terms of the QuickDASH than the elective patients.”
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Tabbaa A, et al. Paper 235. Presented at: American Academy of Orthopaedic Surgeons Annual Meeting; Feb. 12-16, 2024; San Francisco.
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