Müller-Seubert Wibke, Herold Helen, Graf Stephanie, Ludolph Ingo, Horch Raymund E
Department of Plastic and Hand Surgery and Laboratory for Tissue Engineering and Regenerative Medicine, University Hospital Erlangen, Friedrich Alexander University Erlangen-Nürnberg (FAU), 91054 Erlangen, Germany.
J Clin Med. 2022 Sep 5;11(17):5240. doi: 10.3390/jcm11175240.
The exact influence of tourniquet ischemia on a treated extremity remains unclear.
Twenty patients received an operation on one hand under tourniquet ischemia. Twenty healthy volunteers received 10 min of tourniquet ischemia on one of their arms. Measurements of tissue oxygen saturation using near-infrared reflectance-based imaging and skin temperature of the dorsum of the hand were performed at five different timepoints (t0 was performed just before the application of the tourniquet ischemia, t1 directly after the application of the tourniquet ischemia, t2 before the release of the ischemia, t3 directly after the release of the ischemia, and t4 on the following day).
In both groups, tissue oxygen saturation dropped after the application of the tourniquet ischemia compared to t0 and increased after the release of the tourniquet ischemia. In the patient group, tissue oxygen saturation at t4 was higher compared to t0; in contrast, the level of tissue oxygen saturation in the participant group dropped slightly at t4 compared to t0. The measured skin temperature in the patient group showed an increase during the observation period, while it continuously decreased in the group of healthy participants.
Short-term ischemia did not appear to permanently restrict perfusion in this study design. The non-invasive imaging modalities used were easy to handle and allowed repetitive measurement.
止血带缺血对接受治疗的肢体的确切影响尚不清楚。
20例患者在止血带缺血情况下接受单手手术。20名健康志愿者在其一侧手臂接受10分钟的止血带缺血。在五个不同时间点进行基于近红外反射成像的组织氧饱和度测量和手背皮肤温度测量（t0在止血带缺血应用前进行，t1在止血带缺血应用后立即进行，t2在缺血释放前进行，t3在缺血释放后立即进行，t4在第二天进行）。
在两组中，与t0相比，止血带缺血应用后组织氧饱和度下降，止血带缺血释放后升高。在患者组中，t4时的组织氧饱和度高于t0；相比之下，参与者组中t4时的组织氧饱和度水平与t0相比略有下降。患者组测量的皮肤温度在观察期内升高，而健康参与者组中则持续下降。
在本研究设计中，短期缺血似乎并未永久性地限制灌注。所使用的非侵入性成像方式易于操作，并允许重复测量。
