Eficacia de la hemostasia tras retirada del torniquete en la artroplastia de rodilla

Mencía-Barrio, R.; Sánchez-Herráez, S.; Alonso-Barrio, J.A.; Sánchez-Lázaro, J.; Betegón-Nicolás, J.C.; Fernández-Hernández, O.

doi:10.1016/S1888-4415(05)76328-1

Información del artículo

Resumen

Bibliografía

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Estadísticas

Objetivo

El objetivo de este trabajo es comprobar si la hemostasia quirúrgica que se realiza tras la retirada del torniquete en las prótesis totales de rodilla es efectiva para reducir las pérdidas sanguíneas.

Material y método

Se seleccionaron 30 pacientes, a los que se les realizó hemostasia con electrobisturí una vez retirado el torniquete (grupo A) y otros 30 pacientes a los que se les retiró el torniquete una vez cerrada la herida y aplicado el vendaje compresivo (grupo B). Se midieron las pérdidas sanguíneas recogidas por el drenaje aspirativo, los descensos de hemoglobina y hematocrito a las 24 y 48 horas después de la cirugía comparados con los preoperatorios, tiempos de isquemia e intervención y necesidades transfusionales.

Resultados

No se encontraron diferencias estadísticamente significativas en cuanto a las pérdidas sanguíneas (p = 0,836) y requerimientos transfusionales (p= 0,618) entre ambos grupos.

Conclusiones

La hemostasia quirúrgica que se realiza una vez retirado el torniquete no es efectiva para reducir las pérdidas sanguíneas en la artroplastia de sustitución de la rodilla.

Palabras clave:

hemostasia

isquemia

prótesis

rodilla

torniquete

Purpose

The purpose of this study is to determine if surgical hemostasis carried out after tourniquet removal in total knee replacement (TKR) surgery is effective in reducing bleeding.

Materials and methods

In 30 selected patients (Group A) undergoing TKR hemostasis was carried out with electrocautery once the tourniquet was deflated intraoperatively; in another 30 selected patients (Group B) the incision was closed and compressive dressing was applied before tourniquet removal. Blood loss was measured by aspiration drainage, and hemoglobin levels and hematocrit were measured at 24 and 48 hours after surgery and compared with preoperative values, ischemic time was also measured and any transfusions required registered.

Results

No statistically significant differences were found between both groups regarding blood loss (p=0.836) or transfusions required (p= 0.618).

Conclusions

Surgical hemostasis carried out after tourniquet removal is not effective as a way of reducing blood loss in total knee replacement (TKR).

Key words:

hemostasis

ischemia

prosthesis

knee

tourniquet

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