El uso del manguito de isquemia en COT

Abstract

Application of tourniquet during surgery is very common in Orthopaedics. General guidelines are to use a cuff as wide as possible, to pad the tourniquet properly, and to place it distally. The limb should be exanguinated, by elevating and/or using an Esmarch bandage, at least five minutes after the administration of prophylactic antibiotic. The tourniquet should never be hold more than two hours, and in any case, it should be released as soon as possible. Use of lowest effective inflation pressure is the standard, moreover, use of the Limb Occlusion Pressure (LOP) with a safety margin has been currently advocated. It is also recommended to use the tourniquet at least during cementation. In addition, combination of tourniquet with regional anesthesia techniques (wrist and ankle) is becoming more popular. Complications are rare and usually due to a wrong use of the tourniquet. The most common is postoperative pain. Absolute contraindications for the tourniquet are peripheral neuropathy, deep vein thrombosis, Raynaud�s disease and peripheral vascular disease