Uso de Presión de Oclusión de Extremidad como método de cálculo de la presión intraoperatoria del torniquete en tobillo en cirugía del antepié: serie de casos prospectiva

• Javier Pascual Huerta ^[1] ; Leticia Palacio Fernández ^[1] ; Lucía Trincado Villa ^[1] ; Antonio González Fernández ^[1] ; y Eduardo Mongil Escudero ^[2]
  1. [1] Clínica del Pie Elcano. Barakaldo, Vizcaya, España
  2. [2] Servicio de Anestesia y Reanimación. Hospital Universitario de Galdakao, Vizcaya, España
• Localización: Revista española de podología, ISSN 0210-1238, Vol. 35, Nº. 1, 2024, págs. 4-10
• Idioma: español
• DOI: 10.20986/revesppod.2024.1676/2023
• Títulos paralelos:
  • Use of Limb Occlusion Pressure as a method for calculation of intraoperative ankle tourniquet pressure in forefoot surgery: a prospective case series
• Enlaces
  • Texto completo (pdf)
• Resumen
  • español

    Objetivos: El uso de torniquetes en cirugía del pie puede presentar complicaciones. Se valoró la calidad del campo quirúrgico exangüe y la aparición de complicaciones con el uso de torniquete localizado en el tobillo, determinando la presión mediante el método de Presión de Oclusión de Extremidad (POE).

    Pacientes y métodos: Se incluyeron a pacientes intervenidos quirúrgicamente del pie con torniquete en el tobillo. La presión con método POE se determinó con manguito en el tobillo hasta que se perdía el pulso con onda doppler, y al que se añadió un margen de seguridad de 40, 60 u 80 mm Hg si el valor POE era menor de 130, entre 131-190 y mayor de 190 mm Hg, respectivamente. La calidad del campo quirúrgico fue catalogada como Excelente, Buena, Regular y Mala.

    Resultados: Se incluyeron un total de 116 pacientes. La media de presión utilizada fue de 192.73 ± 31.73 mm Hg y el tiempo medio de isquemia 73.92 ± 33.09 minutos. La calidad del campo quirúrgico fue Excelente en 84 casos (72.4 %), Buena en 26 casos (22.4 %) y Regular en 6 casos (5.2 %) sin ningún caso de Mala calidad.

    Conclusiones: El campo quirúrgico fue considerado como Excelente o Bueno en el 94.8 % de los casos con el uso de presiones sensiblemente inferiores a las clásicamente utilizadas en el tobillo para cirugía del pie. El cálculo de la presión del torniquete en el tobillo mediante el método POE es un método válido y fi able que permite un campo quirúrgico exangüe con mínimas complicaciones.

  • English

    Objetives: The use of tourniquets in foot surgery can produce complications. It was assessed que quality of surgical fi eld hemostasis and its complications with the use of an ankle tourniquet whose pressure was determined by using the Limb Occlusion Pressure (LOP) method.

    Patients and methods: Patients surgically treated with an ankle tourniquet were included. Pressure of the tourniquet was calculated using LOP method with a cuff at the ankle until Doppler stethoscope sound was not detected. A security margin was added of 40, 60 or 80 mm Hg if LOP value was less than 130, between 131-190 or more than 190 respectively. Quality of surgical field was graded as Excellent, Good, Fair and Bad.

    Results: A total of 116 patients were included. Mean pressure was 192.73 ± 31.73 mm Hg and mean time of ischemia was 73.92 ± 33.09 minutes. Quality of the surgical fi eld was Excellent in 84 cases (72.4 %), Good in 26 cases (22.4 %) and Fair in 6 cases (5.2 %) with no Bad cases.

    Conclusions: The surgical fi eld was considered Excellent or Good in 94.8% of the cases with ankle pressures noticeably lower than those traditionally used in the ankle for foot surgery. The use of LOP method to calculate tourniquet pressures at the ankle is a valid and safe method that allow a bloodless surgical fi eld with minimal complications.

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