AIM To investigate the total blood loss(TBL) and the safety with respect to the re-amputation rate after transtibial amputation(TTA) conducted with and without a tourniquet. METHODS The study was a single-centre retro...AIM To investigate the total blood loss(TBL) and the safety with respect to the re-amputation rate after transtibial amputation(TTA) conducted with and without a tourniquet. METHODS The study was a single-centre retrospective cohort study of patients with a primary TTA admitted between January 2013 and April 2015. All patients with a primary TTA were assessed for inclusion if the amputation was performed because of arteriosclerosis or diabetic complications. All patients underwent a standardized TTA procedure that was performed approximately 10 cm below the knee joint and performed with sagittalflaps. The pneumatic tourniquet, when used, was inflated around the femur to a pressure of 100 mmH g above the systolic blood pressure. The number of blood transfusions within the first four postoperative days was recorded. The intraoperative blood loss(OBL), which is defined as the volume of blood lost during surgery, was determined from the suction volume and by the weight difference of the surgical dressings. The trigger for a blood transfusion was set at a decrease in the Hgb level < 9.67 g/dL(6 mmol/L). Transfusions were performed with pooled red blood cells containing 245 m L per portion, which equals 55 g/L of haemoglobin. The TBL during the first four postoperative days was calculated based on the haemoglobin level and the estimated blood volume. The re-amputation rate was evaluated within 30 d. RESULTS Seventy-four out of 86 consecutive patients who underwent TTA within the two-year study period were included in the analysis. Of these, 38 were operated on using a tourniquet and 36 were operated on without using a tourniquet. There were no significant preoperative differences between the groups. The patients in both groups had a postoperative decrease in their Hgb level compared with preoperative baseline values. The patients operated on using a tourniquet received approximately three millilitres less blood transfusion per kilogram body weight compared with patients operated on without a tourniquet. The duration of展开更多
文摘AIM To investigate the total blood loss(TBL) and the safety with respect to the re-amputation rate after transtibial amputation(TTA) conducted with and without a tourniquet. METHODS The study was a single-centre retrospective cohort study of patients with a primary TTA admitted between January 2013 and April 2015. All patients with a primary TTA were assessed for inclusion if the amputation was performed because of arteriosclerosis or diabetic complications. All patients underwent a standardized TTA procedure that was performed approximately 10 cm below the knee joint and performed with sagittalflaps. The pneumatic tourniquet, when used, was inflated around the femur to a pressure of 100 mmH g above the systolic blood pressure. The number of blood transfusions within the first four postoperative days was recorded. The intraoperative blood loss(OBL), which is defined as the volume of blood lost during surgery, was determined from the suction volume and by the weight difference of the surgical dressings. The trigger for a blood transfusion was set at a decrease in the Hgb level < 9.67 g/dL(6 mmol/L). Transfusions were performed with pooled red blood cells containing 245 m L per portion, which equals 55 g/L of haemoglobin. The TBL during the first four postoperative days was calculated based on the haemoglobin level and the estimated blood volume. The re-amputation rate was evaluated within 30 d. RESULTS Seventy-four out of 86 consecutive patients who underwent TTA within the two-year study period were included in the analysis. Of these, 38 were operated on using a tourniquet and 36 were operated on without using a tourniquet. There were no significant preoperative differences between the groups. The patients in both groups had a postoperative decrease in their Hgb level compared with preoperative baseline values. The patients operated on using a tourniquet received approximately three millilitres less blood transfusion per kilogram body weight compared with patients operated on without a tourniquet. The duration of
