Orbay Hakan, Unlü Ramazan Erkin, Kerem Metin, Sensöz Omer
Department of 2nd Plastic and Reconstructive Surgery, Ankara Numune Training and Research Hospital, Ankara, Turkey.
Ann Plast Surg. 2006 Jun;56(6):618-21. doi: 10.1097/01.sap.0000203988.88955.bc.
Cessation of blood flow to the extremity improves the comfort of the surgeon. So pneumatic tourniquets are commonly used to obtain a bloodless field during upper- and lower-extremity surgery despite the several problems that tourniquet pressure may lead to. In this paper, we present our clinical experiences with a new tourniquet device called S-MART (OHK Medical Devices, Haifa, Israel) and compared the device with the traditional pneumatic tourniquet in terms of efficacy and complications. A total of 30 patients were included in the study. Preoperative systolic blood pressure measurements were obtained, and patients with a systolic blood pressure >190 mm Hg were excluded. S-MART was used in stead of pneumatic tourniquet in half of the patients in group 1. Pneumatic tourniquet was applied to the patients in group 2. The patient groups were compared. No major complications were observed in either group. But it was observed that S-MART was unsuccessful to maintain a bloodless field during the whole operative procedure in some of the cases. In conclusion, application of S-MART is practical, provides bloodless field for a certain time, and does not increase the complication rate related with the pressure applied to underlying tissues, but it is not a suitable tourniquet device for long surgical procedures.
肢体血流阻断可提高外科医生的操作舒适度。因此，尽管气压止血带压力可能会引发一些问题，但在上、下肢手术中仍普遍使用气压止血带以获得无血手术视野。在本文中，我们介绍了一种名为S-MART（OHK医疗器械公司，以色列海法）的新型止血带装置的临床应用经验，并在有效性和并发症方面将该装置与传统气压止血带进行了比较。共有30例患者纳入本研究。术前测量收缩压，收缩压>190 mmHg的患者被排除。在第1组的一半患者中使用S-MART替代气压止血带。第2组患者使用气压止血带。对两组患者进行比较。两组均未观察到严重并发症。但在某些病例中观察到，S-MART在整个手术过程中未能维持无血手术视野。总之，S-MART的应用具有实用性，能在一定时间内提供无血手术视野，且不会增加与施加于深层组织的压力相关的并发症发生率，但它并非适用于长时间手术的止血带装置。
