Tourniquet use is not associated with limb loss following military lower extremity arterial trauma

The Journal of Trauma and Acute Care Surgery
David S KauvarThomas J Walters

Abstract

The effect of battlefield extremity tourniquet (TK) use on limb salvage and long-term complications following vascular repair is unknown. This study explores the influence of TK use on limb outcomes in military lower extremity arterial injury. The study database includes cases of lower extremity vascular injury from 2004 to 2012 with data recorded until discharge from military service. We analyzed all limbs with at least one named arterial injury from the femoral to the tibial level. Tourniquet (TK) and no TK (NTK) groups were identified. Univariate analyses were performed with significance set at p ≤ 0.05. A total of 455 cases were included, with 254 (56%) having a TK for a median of 60 minutes (8-270 minutes). Explosive injuries (53%) and gunshot wounds (26%) predominated. No difference between TK and NTK was present in presence of fracture, level of arterial injury, type of arterial repair, or concomitant venous injury. More nerve injuries were present in the TK group, and Abbreviated Injury Scale extremity and Mangled Extremity Severity Score tended toward greater injury severity. Amputation and mortality rates did not differ between groups, but the incidence of severe edema, wound infection, and foot drop was higher in the...Continue Reading

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Citations

Jul 6, 2019·The Journal of Trauma and Acute Care Surgery·Andrew DennisFaran Bokhari
May 3, 2019·The Journal of Trauma and Acute Care Surgery·Sixu ChenZhaowen Zong
Mar 26, 2020·Prehospital Emergency Care : Official Journal of the National Association of EMS Physicians and the National Association of State EMS Directors·Nathan P CharltonRobby Nieuwlaat
Oct 2, 2019·The Journal of Trauma and Acute Care Surgery·Sixu ChenZhaowen Zong
Sep 3, 2019·Annals of Vascular Surgery·David S KauvarThomas J Walters
Dec 29, 2020·Curēus·James El HaddiMario Rueda
Feb 2, 2021·Frontiers in Veterinary Science·Thomas H EdwardsAnthony E Pusateri
May 22, 2021·The Journal of Trauma and Acute Care Surgery·David S KauvarJoseph J DuBose
Jun 2, 2021·Anaesthesia Critical Care & Pain Medicine·Julien PottecherHervé Quintard
Jun 3, 2021·European Journal of Emergency Medicine : Official Journal of the European Society for Emergency Medicine·Hugues LefortAnthony Chauvin
Nov 15, 2021·European Journal of Trauma and Emergency Surgery : Official Publication of the European Trauma Society·Alexandre Sabate-FerrisLaurent Mathieu
Oct 22, 2021·The Journal of Trauma and Acute Care Surgery·Richard H LewisLouis J Magnotti
Jan 4, 2022·The American Surgeon·Kennith ColemanJames Bardes

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