Clarke M T, Longstaff L, Edwards D, Rushton N
Orthopaedic Research Unit, University of Cambridge, Addenbrooke's Hospital, Cambridge, England, UK.
J Bone Joint Surg Br. 2001 Jan;83(1):40-4. doi: 10.1302/0301-620x.83b1.10795.
We have investigated whether the thigh tourniquet used during total knee replacement (TKR) influenced the development of postoperative wound hypoxia and was a cause of delayed wound healing. We allocated randomly 31 patients (31 TKRs) to one of three groups: 1) no tourniquet; 2) tourniquet inflated at low pressure (about 225 mmHg); and 3) tourniquet inflated to high pressure of about 350 mmHg. Wound oxygenation was measured using transcutaneous oxygen electrodes. In the first week after surgery, patients with a tourniquet inflated to a high pressure had greater wound hypoxia than those with a low pressure. Those without a tourniquet also had wound hypoxia, but the degree and duration were less pronounced than in either of the groups with a tourniquet. Use of a tourniquet during TKR can increase postoperative wound hypoxia, especially when inflated to high pressures. Our findings may be relevant to wound healing and the development of wound infection.
我们研究了全膝关节置换术（TKR）期间使用的大腿止血带是否会影响术后伤口缺氧的发生，以及是否是伤口愈合延迟的原因。我们将31例患者（31次TKR）随机分配到三组中的一组：1）不使用止血带；2）止血带低压充气（约225 mmHg）；3）止血带高压充气至约350 mmHg。使用经皮氧电极测量伤口氧合情况。术后第一周，止血带高压充气的患者比低压充气的患者有更严重的伤口缺氧。未使用止血带的患者也有伤口缺氧，但程度和持续时间比使用止血带的两组患者都轻。TKR期间使用止血带会增加术后伤口缺氧，尤其是在高压充气时。我们的研究结果可能与伤口愈合和伤口感染的发生有关。
