The Sterile Elastic Exsanguination Tourniquet vs. the Pneumatic Tourniquet for Total Knee Arthroplasty.

We compared the sterile elastic exsanguination tourniquet and the pneumatic tourniquet for total knee arthroplasty. 145 patients were operated on using a pneumatic tourniquet and 166 with the sterile elastic exsanguination tourniquet. Patients with the sterile elastic exsanguination tourniquet had a smaller decrease in hemoglobin on post-operative days one (P<0.028) and three (P<0.045). The amount of blood collected from drains at 24h was significantly lower in the sterile elastic exsanguination group. A trend towards a higher rate of wound complications within 3months following the operation was found in the pneumatic tourniquet group. The sterile elastic exsanguination tourniquet works at least as good as the pneumatic one.

Use of the HemaClear™ elastic tourniquet reduces blood loss in operative treatment of humeral shaft fractures.

BACKGROUND: To determine if the use of a narrower elastic tourniquet compared to a standard pneumatic tourniquet reduces operative blood loss in the operative fixation of humeral shaft fractures. METHODS: This retrospective cohort study was performed at a level I trauma center and included 134 patients, aged 18 to 90 years, with a humeral shaft fracture treated with open reduction internal fixation (ORIF) from January 2007 through June 2018. The primary variable of interest was the application of a HemaClear™ elastic tourniquet versus a standard pneumatic tourniquet during the fixation of a humeral shaft fracture. The primary outcome was estimated blood loss (EBL) during the humerus ORIF surgery as recorded in the operative record. The secondary outcomes were total tourniquet time and operative time. The primary purpose of the study was to compare the above outcomes between the two tourniquet types. RESULTS: Estimated blood loss was 42% lower (95% CI: 11% to 73%, p < 0.01) in the elastic tourniquet group when compared to the standard pneumatic tourniquet group. The use of the elastic tourniquet was also associated with a 67% increase (95% CI: 35% to 100%, p < 0.01) in tourniquet time compared to the standard pneumatic tourniquet. No difference in the total operative time between the two groups (difference, -3%; 95% CI: -21 to 14, p = 0.72) was observed. CONCLUSION: Elastic tourniquet use was associated with 42% less blood loss in the fixation of humeral shaft fractures compared to use of a traditional pneumatic tourniquet, although this may be of unclear clinical importance given the relatively low estimated blood loss in this cohort. The potential benefit of reduced blood loss associated with the narrower elastic tourniquet is likely caused by the increased tourniquet time, without a change in overall operative time.