Relationship between the Tourniquet Pressure and the Amount of Subcutaneous Bleeding after Total Knee Replacement
The Journal of Korean Knee Society
Purpose: We wanted to evaluate the post-operative amount of subcutaneous bleeding according to the tourniquet pressure during total knee replacement. Materials and Methods: We analyzed 136 patients who had undergone total knee replacement at our hospital from March 4th, 2010 to September 16th, 2010. A tourniquet pressure of 250 mm Hg was applied to 69 patients (group I) and a tourniquet pressure of 320 mm Hg was applied to the other 67 patients (group II). Subcutaneous bleeding was evaluated on
... the 3rd and 6th days after the operations. All of the total knee replacements were performed by a single surgeon. Results: Among the group I patients, subcutaneous bleeding was seen in just 2 patients, yet among the group II patients, there were 32 patients with subcutaneous bleeding on the 3rd day and 33 patients with subcutaneous bleeding on the 6th day. According to the multiple regression analysis, there were no significant differences in ages, the tourniquet time and the orders between the two groups. Group 1 had significantly less subcutaneous bleeding than did group II on the 3rd and 6th days after the operations (p=0.001). Conclusion: There was a significant difference of the amount of subcutaneous bleeding amount according to the tourniquet pressure. We were able to decrease the post-operative amount of subcutaneous bleeding after total knee replacement by lowering the tourniquet pressure to 250 mm Hg. 서 론 인공 슬관절 전치환술을 비롯한 대부분의 정형외과적 수술에서 지혈대는 수술 시야의 확보와 출혈을 감소시키 기 위한 목적으로 흔히 사용되고 있으나 근육과 혈관, 신 경 등, 연부 조직을 압박함으로써 이들 조직을 손상시키 고, 대퇴부 동통, 피하출혈을 발생시키며 심혈관계 문제 등의 여러 부작용들을 일으키는 것으로 알려져 있다. 이러 한 합병증의 발생을 감소시키기 위하여 지혈대의 압력을 낮추는 것이 도움이 될 것이라는 가정하에, 저자들은 인공 슬관절 전치환술 시 통상적으로 사용되어 왔던 320 mm Hg 지혈대의 압력을 250 mm Hg로 낮춰, 단기 합병증 중 의 하나이며 측정이 용이하고, 혈관손상과 관련이 깊은 피 하 출혈의 발생 정도를 비교해 보고자 하였다.