Tourniquet Use for Ankle Fracture Surgery
What You Need to Know Before You Apply
What is the purpose of this trial?
This trial examines how using a tourniquet (a tight band that stops blood flow) during ankle fracture surgery might affect muscle health and recovery. Researchers aim to determine if outcomes differ between surgeries with an inflated tourniquet and those without. Individuals undergoing surgery to fix a broken ankle, without other serious injuries, might be suitable candidates. The goal is to discover whether a tourniquet aids or hinders recovery after surgery. As an unphased trial, this study allows participants to contribute to important research that could enhance surgical outcomes for future patients.
Will I have to stop taking my current medications?
The trial information does not specify whether you need to stop taking your current medications.
What prior data suggests that tourniquet use is safe for ankle fracture surgery?
Research shows that using a tourniquet during ankle fracture surgery is generally safe, though it can have some side effects. Studies have found that a tourniquet may cause more ankle swelling after surgery. For instance, one study noted that patients with a tourniquet experienced more swelling, measuring 19 mm, compared to 10 mm in those without a tourniquet, up to six weeks post-surgery.
Additionally, using a tourniquet might slightly increase the length of hospital stays. On average, patients with a tourniquet stayed about 1.79 days in the hospital, compared to 1.65 days for those without one. Using a tourniquet for up to 3 hours at pressures up to 300 mmHg does not seem to cause major wound problems.
While tourniquets can lead to more swelling and longer hospital stays, they do not appear to cause serious long-term harm. Although there are some risks, many patients handle tourniquets without major issues.12345Why are researchers excited about this trial?
Researchers are excited about the use of a tourniquet for ankle fracture surgery because it offers a potentially safer and more efficient method to control bleeding during the procedure. While traditional methods may not utilize a tourniquet, this approach involves inflating the tourniquet around the thigh to a specific pressure, which could improve the surgical field visibility and reduce operative time. This technique might also lead to less blood loss and quicker recovery times for patients, making it a promising alternative to current surgical practices. By comparing outcomes with and without the tourniquet, researchers hope to determine the optimal strategy for managing ankle fractures surgically.
What evidence suggests that tourniquet use is effective for ankle fracture surgery?
This trial will compare the use of a tourniquet with no tourniquet during ankle fracture surgery. Research has shown that using a tourniquet in such surgeries does not clearly improve outcomes. A review of studies found that tourniquets might reduce pain and shorten hospital stays, but strong evidence for this is lacking specifically in ankle fractures. Some studies indicate that while tourniquets can help keep the area blood-free for the surgeon, they don't significantly affect surgery duration or complication rates. Additionally, using a tourniquet can create challenges, such as increased risk for the anesthesiologist. Overall, current research leaves the benefits of using tourniquets in ankle surgeries uncertain.13678
Who Is on the Research Team?
Lara Atwater, MD
Principal Investigator
Oregon Health and Science University
Are You a Good Fit for This Trial?
Adults aged 18 to 89 who are having surgery for an ankle fracture at OHSU can join this trial. It's not for those with other major bone or internal injuries, including on the same limb, or people with sepsis.Exclusion Criteria
Timeline for a Trial Participant
Screening
Participants are screened for eligibility to participate in the trial
Surgery
Participants undergo ankle fracture surgery with or without tourniquet use
Postoperative Monitoring
Continuous intramuscular pH monitoring and initial recovery
Follow-up
Participants are monitored for functional measures and patient-reported outcomes
What Are the Treatments Tested in This Trial?
Interventions
- Tourniquet
Trial Overview
The study is looking at how using a tourniquet during ankle surgery affects muscle pH levels and if there's any link between its use and how well patients recover functionally and what they report about their outcomes after surgery.
How Is the Trial Designed?
2
Treatment groups
Active Control
This arm will have a tourniquet placed around the thigh inflated to 250mmHg for the duration of surgery (until splint placed) or 2 hours, whichever is shorter, during ankle fracture surgery.
This arm will have a tourniquet placed around the thigh but NOT inflated for the duration of ankle fracture surgery.
Find a Clinic Near You
Who Is Running the Clinical Trial?
Oregon Health and Science University
Lead Sponsor
Published Research Related to This Trial
Citations
Meta-analysis on the efficacy of tourniquet on ankle trauma ...
Smith et al. reported a meta-analysis of the efficacy of the tourniquet on foot and ankle surgery, suggesting that pain was reduced and hospital stay was ...
Tourniquet use in ankle arthroscopy: A systematic review
All studies showed no statistically significant difference in mean surgical time and complication rate between the tourniquet and non-tourniquet groups. ...
Tourniquet Use for Ankle Fracture Surgery
Therefore, the effectiveness of tourniquet use in improving surgical outcomes for ankle fractures is not clearly supported by the available data.
4.
journals.lww.com
journals.lww.com/ejanaesthesiology/fulltext/2014/06001/tourniquet_use_during_ankle_surgery_leads_to.681.aspxTourniquet use during ankle surgery leads to increased...
Tourniquet gives the surgeon a bloodless field and decreases blood loss, but it also leads to a number of challenges for the anaesthesiologist in the ...
Effect of ankle versus thigh tourniquets on post-operative ...
It included 42 patients and demonstrated significantly less foot pain in the ankle tourniquet group within two weeks after surgery and higher ...
The risks associated with tourniquet use in lower limb trauma ...
Tourniquet use was associated with greater ankle swelling up to six weeks post-operatively (10 mm versus 19 mm, p < 0.01) compared to surgery ...
Effect on Hospital Length of Stay of Tourniquet Use During ...
As a secondary outcome, duration of operation was analyzed by analysis of covariance. Mean LOS was 1.79 ± 1.50 days in the tourniquet group and 1.65 ± 1.11 days ...
Extended Tourniquet Times and the Impact on Wound ...
This study suggests that tourniquet times from 2 to 3 hours in foot and ankle surgery with pressures up to 300 mmHg are not associated with a significant ...
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