Day Brian
Department of Orthopaedics, University of British Columbia, Vancouver, Canada.
Arthrosc Sports Med Rehabil. 2025 Feb 20;7(3):101106. doi: 10.1016/j.asmr.2025.101106. eCollection 2025 Jun.
To investigate current practices for tourniquet use, including tourniquet times, indications, and other perioperative applications, among Arthroscopy Association of North America (AANA) members and to determine whether recommendations can be made for safer tourniquet use.
Participants in this study were AANA members who responded to our survey in the AANA DocMatter Community. The survey was developed based on discussion prompts in DocMatter. The survey consisted of 28 questions on 4 core themes, including demographic characteristics, general understanding of tourniquet safety, applied tourniquet use in arthroscopy, and tourniquet technology in perioperative applications. The survey was open for responses for 7 weeks from September to November 2023. Multiple-choice responses were counted, and short-form responses were reviewed and aggregated based on keywords. Qualitative analysis was used to understand the data.
A total of 59 AANA DocMatter Community Members participated in the survey. Eighty percent of respondents had been in practice for more than 10 years, whereas 20% had been in practice for between 3 and 10 years. Tourniquet usage in arthroscopy was varied, although some patterns were detected. For example, 91% of responders applied tourniquets for all limb procedures, but many inflated them only as needed, and some preferred not to use a tourniquet. When tourniquet times were minimized by selectively inflating cuffs, tourniquet times averaged between 15 and 20 minutes compared with 20 to 60 minutes for continuous inflation. However, 76% of participants reported encountering venous congestion when a tourniquet was applied but not inflated. Perioperative tourniquet uses were also varied. Almost half of respondents used tourniquets for blood flow restriction therapy in their care protocols. In a separate possible trend, a majority of respondents were interested in using tourniquet-related technology to help resolve postsurgical lymphedema.
Despite large reported variation in the indications for tourniquet use and the control of key tourniquet parameters, use is evolving through a focus on optimizing tourniquet times through selective inflation for specific aspects of arthroscopic procedures.
Standardized approaches to the safe use of tourniquets and their evolving applications are important areas of investigation.
调查北美关节镜协会（AANA）成员目前使用止血带的情况，包括止血带使用时间、适应症及其他围手术期应用情况，并确定是否能就更安全地使用止血带提出建议。
本研究的参与者为在AANA DocMatter社区回复我们调查问卷的AANA成员。该调查问卷是根据DocMatter中的讨论提示编写的。问卷包含28个关于4个核心主题的问题，包括人口统计学特征、对止血带安全性的总体认识、关节镜检查中止血带的实际使用情况以及围手术期应用中的止血带技术。该调查于2023年9月至11月开放7周以供回复。对多项选择题的回答进行计数，对简短回答根据关键词进行审查和汇总。采用定性分析来理解数据。
共有59名AANA DocMatter社区成员参与了调查。80%的受访者从业超过10年，而20%的受访者从业3至10年。关节镜检查中止血带的使用情况各不相同，不过也发现了一些模式。例如，91%的受访者在所有肢体手术中都使用止血带，但许多人仅在需要时充气，还有一些人更倾向于不使用止血带。当通过选择性充气使止血带使用时间最短化时，止血带平均使用时间在15至20分钟之间，而持续充气时为20至60分钟。然而，76%的参与者报告在应用但未充气止血带时遇到静脉充血情况。围手术期止血带的使用情况也各不相同。近一半的受访者在其护理方案中使用止血带进行血流限制治疗。在另一个可能的趋势中，大多数受访者对使用与止血带相关的技术来帮助解决术后淋巴水肿感兴趣。
尽管据报道止血带使用适应症和关键止血带参数控制存在很大差异，但通过专注于在关节镜手术的特定方面进行选择性充气以优化止血带使用时间，其使用方式正在不断演变。
安全使用止血带的标准化方法及其不断演变的应用是重要的研究领域。
