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Tourniquete

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https://www.readbyqxmd.com/read/28725505/long-volar-plating-for-metadiaphyseal-fractures-of-distal-radius-study-comparing-minimally-invasive-plate-osteosynthesis-versus-conventional-approach
#1
Emilie Pire, Juan José Hidalgo Diaz, Santiago Salazar Botero, Sybille Facca, Philippe A Liverneaux
Background  Minimally invasive plate osteosynthesis (MIPO) has been used in wrist surgery for several years. The purpose of this retrospective study was to compare clinical and radiologic outcomes of MIPO technique with those of a conventional approach in the treatment of metadiaphyseal distal radius fracture by long volar plating. Materials and Methods  Our series consisted of 32 fractures in 31 patients, mean age 63.9 years, including 16 men and 15 women. MIPO technique was used in 15 wrists (group 1) and conventional approach (> 60 mm of skin incision) in 17 wrists (group 2)...
August 2017: Journal of Wrist Surgery
https://www.readbyqxmd.com/read/28718350/tourniquet-deflation-prior-to-20-minutes-in-upper-extremity-intravenous-regional-anesthesia
#2
Richard W Gurich, Justin W Langan, Robert J Teasdall, Stephanie L Tanner, John L Sanders
BACKGROUND: Bier blocks, or intravenous regional anesthesia (IVRA), are a method of anesthesia for upper extremity surgeries. This study reports our experience with tourniquet deflation prior to 20 minutes with upper extremity IVRA. METHODS: This study was designed as a retrospective cohort analysis. Records, including intraoperative and immediate postoperative anesthesia notes, of 430 patients who underwent IVRA with an upper extremity Bier block and a corresponding tourniquet time of less than 20 minutes were reviewed...
January 1, 2017: Hand: Official Journal of the American Association for Hand Surgery
https://www.readbyqxmd.com/read/28718308/ulnar-shortening-versus-distal-radius-corrective-osteotomy-in-the-management-of-ulnar-impaction-after-distal-radius-malunion
#3
William R Aibinder, Ali Izadpanah, Bassem T Elhassan
BACKGROUND: Distal radius malunions lead to functional deficits. This study compares isolated ulnar shortening osteotomy (USO) to distal radius osteotomy (DRO) for the treatment of ulnar impaction syndrome following distal radius malunion. METHODS: We retrospectively reviewed 11 patients with extra-articular distal radius malunions treated for ulnar impaction with isolated USO. This group was compared to a 1:1 age- and sex-matched cohort treated with isolated DRO for the same indication...
January 1, 2017: Hand: Official Journal of the American Association for Hand Surgery
https://www.readbyqxmd.com/read/28706378/soft-tissue-damage-during-total-knee-arthroplasty-focus-on-tourniquet-induced-metabolic-and-ionic-muscle-impairment
#4
REVIEW
Constantin Mayer, Alexander Franz, Jan-Frieder Harmsen, Fina Queitsch, Michael Behringer, Johannes Beckmann, Rüdiger Krauspe, Christoph Zilkens
PURPOSE: Advantages of tourniquet use in TKA include benefits for surgeons and patients, varying from a bloodless operation site to a reduced intervention time. The time under ischemia and the reperfusion period are crucial phases for affected soft-tissue, most commonly the extensor mechanism. CASE REPORTS: documented its impact on soft-tissue, ranging from necrotic muscle damage to systemic inflammation. Recently, research regarding tourniquet application patterns discuss clinical outcome parameters in the context of soft-tissue damage, excluding the underlying pathophysiological mechanisms...
September 2017: Journal of Orthopaedics
https://www.readbyqxmd.com/read/28700413/venous-thromboembolism-after-major-venous-injuries-competing-priorities
#5
Brian Frank, Zoё Maher, Joshua P Hazelton, Shelby Resnick, Elizabeth Dauer, Anna Goldenberg, Andrea L Lubitz, Brian P Smith, Noelle N Saillant, Patrick M Reilly, Mark J Seamon
BACKGROUND: Venous thromboembolism (VTE) after major vascular injury (MVI) is particularly challenging as the competing risk of thrombosis and embolization after direct vessel injury must be balanced with risk of bleeding after surgical repair. We hypothesized that venous injuries, repair type and intraoperative anticoagulation would influence VTE formation after MVI. METHODS: A multi-institution, retrospective cohort study of consecutive MVI patients was conducted at 3 urban, level-I centers (2005-2013)...
July 12, 2017: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/28697860/multimodal-nutritional-management-in-primary-total-knee-arthroplasty-a-randomized-controlled-trial
#6
Guorui Cao, Qiang Huang, Bin Xu, Zeyu Huang, Jinwei Xie, Fuxing Pei
BACKGROUND: This study aims at evaluating the effectiveness of a new multimodal nutritional management (MNM) on albumin (ALB) transfusion, the incidence of electrolyte disorders, blood loss, perioperative levels of ALB and electrolyte, length of hospital stay (LOH), and complications in patients following total knee arthroplasty without tourniquet. METHODS: A total of 162 patients were randomized to receive either the MNM protocol (n = 81, experimental group) or traditional protocol (n = 81, control group)...
June 17, 2017: Journal of Arthroplasty
https://www.readbyqxmd.com/read/28697026/smartphone-based-mobile-thermal-imaging-technology-to-assess-limb-perfusion-and-tourniquet-effectiveness-under-normal-and-blackout-conditions
#7
Morgan R Barron, John P Kuckelman, John M McClellan, Michael J Derickson, Cody J Phillips, Shannon T Marko, Joshua P Smith, Matthew J Eckert, Matthew J Martin
BACKGROUND: Over the past decade there has been a resurgence of tourniquet use in civilian and military settings. Several key challenges include assessment of limb perfusion and adequacy of tourniquet placement, particularly in the austere or pre-hospital environments. We investigated the utility of thermal imaging to assess adequacy of tourniquet placement. METHODS: The FLIR ONE™ smartphone-based thermal imager was utilized. Ten swine underwent tourniquet placement with no associated hemorrhage (n=5) or with 40% hemorrhage (n=5)...
July 8, 2017: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/28693848/does-penile-tourniquet-application-alter-bacterial-adhesion-to-rat-urethral-cells-an-in-vitro-study
#8
Ozlem Boybeyi-Turer, Birgul Kacmaz, Esra Arat, Pınar Atasoy, Ucler Kisa, Yasemin Dere Gunal, Mustafa Kemal Aslan, Tutku Soyer
PURPOSE: To investigate the effects of penile tourniquet (PT) application on bacterial adhesion to urothelium. METHODS: Fifty-six rats were allocated into control group (CG), sham group (SG), PT group (PTG). No intervention was applied in CG. A 5mm-length urethral repair was performed in SG and PTG. In PTG, a 10-min duration of PT was applied during the procedure and the tissue oxygenation monitor was used to adjust the same degree of ischemia in all subjects. Samples were examined for wound healing parameters and tissue levels of inflammatory markers, eNOS, e-selectin, and ICAM-1antibodies...
June 28, 2017: Journal of Pediatric Surgery
https://www.readbyqxmd.com/read/28673619/performing-hand-surgery-under-local-anesthesia-without-a-tourniquet-in-china
#9
REVIEW
Jin Bo Tang, Ke Tong Gong, Lai Zhu, Zhang Jun Pan, Shu Guo Xing
In China, wide-awake surgeries are increasingly used by surgeons in a growing number of hospitals for hand and upper extremity surgeries. Experience suggests that wide-awake surgery is safe, economical, and patient-friendly, optimizing hospital resource allocation and increasing efficiency. This article discusses which procedures are most suitable, variations in procedures, departmental impacts, and future direction.
August 2017: Hand Clinics
https://www.readbyqxmd.com/read/28660135/perioperative-blood-management-strategies-for-patients-undergoing-total-knee-replacement-where-do-we-stand-now
#10
REVIEW
Tzatzairis Themistoklis, Vogiatzaki Theodosia, Kazakos Konstantinos, Drosos I Georgios
Total knee replacement (TKR) is one of the most common surgeries over the last decade. Patients undergoing TKR are at high risk for postoperative anemia and furthermore for allogeneic blood transfusions (ABT). Complications associated with ABT including chills, rigor, fever, dyspnea, light-headedness should be early recognized in order to lead to a better prognosis. Therefore, perioperative blood management program should be adopted with main aim to reduce the risk of blood transfusion while maximizing hemoglobin simultaneously...
June 18, 2017: World Journal of Orthopedics
https://www.readbyqxmd.com/read/28657831/case-report-life-saving-application-of-commercial-tourniquet-in-pediatric-extremity-hemorrhage
#11
David W Callaway, Andrew Puciaty, Josh Robertson, Tony Hannon, Sarah E Fabiano
Hemorrhage is the leading preventable cause of death in civilian and military trauma. Recent data from the ongoing conflicts in Iraq and Afghanistan suggest that early and aggressive tourniquet utilization is a safe and effective way to dramatically reduce mortality from extremity hemorrhage. As a result, prehospital tourniquet use is now endorsed by a majority of professional emergency medicine, emergency medical service and trauma professional societies. However, there currently exists scant evidence supporting the efficacy of commercially available tourniquets in controlling extremity hemorrhage in pediatric trauma patients...
June 28, 2017: Prehospital Emergency Care
https://www.readbyqxmd.com/read/28657396/preoperative-methylprednisolone-does-not-reduce-loss-of-knee-extension-strength-after-total-knee-arthroplastya-randomized-double-blind-placebo-controlled-trial-of-61-patients
#12
Viktoria Lindberg-Larsen, Thomas Q Bandholm, Camilla K Zilmer, Jens Bagger, Mette Hornsleth, Henrik Kehlet
Background and purpose - Patients undergoing total knee arthroplasty (TKA) face challenges related to postoperative reduction in knee-extension strength. We evaluated whether inhibition of the inflammatory response by a single preoperative dose of methylprednisolone (MP) reduces the pronounced loss of knee-extension strength at discharge after fast-track TKA. Patients and methods - 70 patients undergoing elective unilateral TKA were randomized (1:1) to preoperative intravenous (IV) MP 125 mg (group MP) or isotonic saline IV (group C)...
June 28, 2017: Acta Orthopaedica
https://www.readbyqxmd.com/read/28654613/evidence-based-medicine-current-evidence-in-the-diagnosis-and-management-of-carpal-tunnel-syndrome
#13
Steven J Hermiz, Loree K Kalliainen
LEARNING OBJECTIVES: After studying this article, the participant should be able to: 1. Create a safe and effective plan for management of carpal tunnel syndrome. 2. Support his or her rationale for the use of diagnostic tests. 3. Discuss elements of management that have been controversial, including anesthesia, the use of a tourniquet, postoperative pain control, and cost of care. SUMMARY: This is the fourth MOC-PS CME article on carpal tunnel syndrome. Each of the prior three has had a slightly different focus, and the reader is invited to review all to generate a comprehensive view of the management of this common, and often controversial, topic...
July 2017: Plastic and Reconstructive Surgery
https://www.readbyqxmd.com/read/28645218/wide-awake-anesthesia-in-the-in-office-procedure-room-lessons-learned
#14
Robert E Van Demark, Hillary A Becker, Matthew C Anderson, Vanessa J S Smith
BACKGROUND: Wide-awake local anesthesia and no tourniquet (WALANT) has become more popular in hand surgery. Without a tourniquet, there is no need for preoperative testing or sedation. The use of lidocaine with epinephrine has allowed a larger variety of cases to be done safely in an outpatient setting instead of the hospital. "Minor field sterility," which uses fewer drapes and tools to accomplish the same procedures, is a concept that is also gaining recognition. METHODS: Investigation of hand surgeons performing a majority of cases using WALANT and minor field sterility was the beginning of seeing its potential at our institution...
June 1, 2017: Hand: Official Journal of the American Association for Hand Surgery
https://www.readbyqxmd.com/read/28644939/an-economic-analysis-of-mac-versus-walant-a-trigger-finger-release-surgery-case-study
#15
Jason L Codding, Suneel B Bhat, Asif M Ilyas
BACKGROUND: There has been recent interest in wide awake hand surgery, also referred to as "wide awake local anesthesia with no tourniquet" (WALANT) surgery. Using a model of single trigger finger release (TFR) surgery, a hypothesis was made that WALANT would result in decreased hospital time and cost than patients receiving sedation with monitored anesthetic care (MAC). METHODS: Consecutive cases of single TFR surgery with MAC were compared with WALANT. All surgeries were performed in the same manner, at the same facility, and by the same surgeon...
July 2017: Hand: Official Journal of the American Association for Hand Surgery
https://www.readbyqxmd.com/read/28618761/the-effects-of-iloprost-and-alprostadil-on-ischemia-reperfusion-injury-in-preventing-inflammation-tissue-degeneration-and-apoptosis-in-rat-skeletal-muscle
#16
Elif Güneysu, Atacan Emre Koçman, Orhan Özatik, Cengiz Ovali, Betül Can, İbrahim Özkan Alataş, Mustafa Behçet Sevin
BACKGROUND/AIM: The protective effects of prostaglandin (PG) analogs on ischemia-reperfusion (I/R) have been well documented; however, comparative studies are lacking. The aim of the present study was to determine whether iloprost or alprostadil is more effective in preventing muscle I/R injury. MATERIALS AND METHODS: Thirty-two rats were divided into four groups (n = 8): sham, control, IL (I/R + iloprost), and AL (I/R + alprostadil). I/R was induced by a tourniquet in the hindlimb for 3 h/3 h...
June 12, 2017: Turkish Journal of Medical Sciences
https://www.readbyqxmd.com/read/28601208/bleeding-control-with-limb-tourniquet-use-in-the-wilderness-setting-review-of-science
#17
REVIEW
John F Kragh, Michael A Dubick
The purpose of this review is to summarize tourniquet science for possible translation to wilderness settings. Much combat casualty data has been studied since 2005, and use of tourniquets in the military has changed from a last resort to first aid. The US Government has made use of tourniquets a health policy aimed to improve public access to bleeding control items. International authorities believe that education in first aid should be universal, as all can and should learn first aid. The safety record of tourniquet use is mixed, but users are reliably safe if trained well...
June 2017: Wilderness & Environmental Medicine
https://www.readbyqxmd.com/read/28601205/remote-damage-control-resuscitation-in-austere-environments
#18
REVIEW
Ronald Chang, Brian J Eastridge, John B Holcomb
Hemorrhage is the leading cause of preventable military and civilian trauma death. Damage control resuscitation with concomitant mechanical hemorrhage control has become the preferred in-hospital treatment of hemorrhagic shock. In particular, plasma-based resuscitation with decreased volumes of crystalloids and artificial colloids as part of damage control resuscitation has improved outcomes in the military and civilian sectors. However, translation of these principles and techniques to the prehospital, remote, and austere environments, known as remote damage control resuscitation, is challenging given the resource limitations in these settings...
June 2017: Wilderness & Environmental Medicine
https://www.readbyqxmd.com/read/28599052/tccc-updates-two-decades-of-saving-lives-on-the-battlefield-tactical-combat-casualty-care-turns-20
#19
Frank K Butler
BACKGROUND: Twenty years ago, the original Tactical Combat Casualty Care (TCCC) article was published in this journal. Since TCCC is essentially a set of bestpractice prehospital trauma care guidelines customized for use on the battlefield, the presence of a journal with a specific focus on military medicine was a profound benefit to the initial presentation of TCCC to the US Military. METHODS: In the two ensuing decades, which included the longest continuous period of armed conflict in our nation's history, TCCC steadily evolved as the prehospital trauma care evidence base was augmented and as feedback from user medics, corpsmen, and pararescuemen was obtained...
2017: Journal of Special Operations Medicine: a Peer Reviewed Journal for SOF Medical Professionals
https://www.readbyqxmd.com/read/28599033/assessment-of-trainer-skill-to-control-groin-wound-bleeding-use-of-junctional-tourniquet-models-on-a-manikin
#20
John F Kragh, James K Aden, Stacy Shackelford, Virgil K Moore, Michael A Dubick
BACKGROUND: The purpose of this study was to assess the skills of trainers using different junctional tourniquet models to control groin bleeding in a manikin. MATERIALS AND METHODS: In 204 assessments, 17 trainers used four junctional tourniquet models three times each to control simulated hemorrhage. The models included the Combat Ready Clamp (CRoC), Junctional Emergency Treatment Tool (JETT), Abdominal Aortic and Junctional Tourniquet (AAJT), and SAM Junctional Tourniquet (SJT)...
2017: Journal of Special Operations Medicine: a Peer Reviewed Journal for SOF Medical Professionals
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