One-per-mil tumescent technique for bone and joint surgery in hand

Hand : Official Journal of the American Association for Hand Surgery
Theddeus O H PrasetyonoWindi Astriana

Abstract

This study aims to explore the effectiveness of one-per-mil tumescent technique in hand surgery, which involves bone and joint. This is a case series study on 14 patients with 15 operative fields. One-per-mil solution is formulated by mixing 0.05 mL of 1:1,000 epinephrine and 100 mg lidocaine in 50-mL saline solution. The solution was injected subcutaneously into the operative area until the skin turned pale. The surgery started 7-10 min after the last injection. We classified the operative field clarity into four categories: totally bloodless, minimum bleeding, acceptable bleeding, and bloody operative field. We also recorded the amount of tumescent solution, top-ups needed, length of surgery, type of anesthesia, and intraoperative pain reported by the patients under local anesthesia. Five patients were operated on under local anesthesia while the other ten were under general anesthesia. Eight cases yielded totally bloodless operative fields, while seven were classified as acceptable bleeding. There were no top-ups and conversion of anesthesia needed during surgery. We consider one-per-mil tumescent technique as a promising successor of pneumatic tourniquet in bone and joint surgery, especially for lengthy procedures on hand a...Continue Reading

References

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Citations

May 25, 2016·Archives of Plastic Surgery·Theddeus O H Prasetyono, Puri A Lestari

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Methods Mentioned

BETA
sedation
amputation
X-ray

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