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The following is a summary of “Effects of tourniquet use in elbow surgery: a retrospective analysis,” published in the July 2024 issue of Surgery by Hoffeld et al.

Pneumatic tourniquets are commonly used in extremity surgeries to improve intraoperative visibility and reduce blood loss. While their benefits and risks have been well-documented in lower limb procedures, their impact on upper limb surgeries, particularly elbow surgery, is less understood. This study evaluates the advantages and risks associated with pneumatic tourniquet use in elbow surgeries for fractures. A retrospective analysis was conducted on 183 patients who underwent elbow surgery between January 2019 and September 2023. Patients were divided into two groups: those who had surgery with a tourniquet (WT) and those without (NT). Subgroup analyses were performed based on fracture complexity. 

Data collected included patient demographics, tourniquet usage, surgery duration, pre-and postoperative hemoglobin levels, C-reactive protein levels, pain scores, opioid use, hospital stay length, follow-up data, complications, and revision surgeries. Statistical analyses identified significant differences and correlations between the two groups. The results demonstrated that patients in the WT group experienced significantly shorter surgery durations and hospital stays, along with a smaller drop in hemoglobin, indicating reduced blood loss. However, no significant differences were observed in postoperative pain, opioid consumption, or complication rates between the WT and NT groups. 

Subgroup analysis highlighted that shorter surgical durations were more evident in complex fracture cases treated with a tourniquet. These findings suggest that pneumatic tourniquet use in elbow surgery offers improved surgical efficiency and reduced blood loss without compromising patient outcomes. However, given the potential influence of perioperative decision-making on tourniquet application, further research is needed to fully understand its role and optimize its use, particularly in complex elbow fractures.

Source: sciencedirect.com/science/article/pii/S1058274624005020