Effect of tourniquet combined with exsanguination band use on short-term lower extremity venous thrombosis after knee arthroscopy

doi:10.12307/2022.173

Abstract

Abstract: BACKGROUND: The incidence of lower extremity deep venous thrombosis after knee arthroscopy is between 0.27% and 17.5%, so it is of great significance to actively prevent the occurrence of lower extremity deep venous thrombosis after knee arthroscopy.
OBJECTIVE: To investigate the effect of using exsanguination band under routine tourniquet during knee arthroscopy on the incidence of lower extremity venous thrombosis in the early postoperative period.
METHODS: Totally 200 patients between the ages of 40 and 60 years who underwent knee arthroscopic surgery in the Taihe Hospital of Hubei Medical College from June 2019 to December 2020 were included, including 100 patients in the driven blood band group and 100 patients in the leg raising driven blood group. Pressure tourniquet was used to stop bleeding in both groups after blood evacuation. Blood coagulation was detected in both groups 1 day before operation, 1, 3, 7, and 14 days after operation. Color Doppler ultrasound of the lower extremity veins was performed 2 days after the operation to evaluate the occurrence of lower extremity vein thrombus. Motion range of the knee was compared between the two groups at 1, 3, and 7 days after operation. This study was approved by the Taihe Hospital of Hubei Medical College (approval No. 2021KS096).
RESULTS AND CONCLUSION: (1) Prothrombin time, activated partial thromboplastin time, and D-dimer level were increased after operation compared with those before operation in both groups. Prothrombin time, activated partial thromboplastin time, and D-dimer level were increased at 1, 3 and 7 days postoperatively in the driven blood band group compared with the leg raising driven blood group (P < 0.05). There was no significant difference between the two groups at 14 days postoperatively (P > 0.05). (2) Color Doppler ultrasound examination showed that there was no deep venous thrombosis in the lower extremities between the two groups, but there were more intermuscular venous thrombosis in the lower extremities. The incidence of intermuscular venous thrombosis was higher in the driven blood band group than that in the leg raising driven blood group (28%, 16%, P < 0.05). (3) There was no significant difference in motion range of the knee after operation in both groups (P > 0.05). (4) Results suggest that tourniquet combined with exsanguination band use can aggravate the hypercoagulable state of patients after knee arthroscopy, which increases the incidence of intermuscular venous thrombosis in the lower extremities and the risk of secondary pulmonary embolism caused by this, but will not increase the incidence of deep vein thrombosis in the lower extremities after surgery.

Key words: tourniquet, exsanguination band, knee arthroscopy, lower extremity deep vein thrombosis, intermuscular vein thrombosis, pulmonary artery embolism, coagulation function, knee motion range

CLC Number:

Yang Yang, Li Naxi, Zhang Jian, Wang Mian, Gong Taifang, Gu Liuwei. Effect of tourniquet combined with exsanguination band use on short-term lower extremity venous thrombosis after knee arthroscopy[J]. Chinese Journal of Tissue Engineering Research, 2022, 26(6): 898-903.

Figures/Tables 8

References

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