Releasing of Tourniquet Before Wound Closure or not in Total Knee Arthroplasty: A Meta-Analysis of Randomized Controlled Trials

Abstract The purpose of this study is to examine our hypothesis that releasing tourniquet intraoperatively before wound closure is better than releasing postoperatively after wound closure and bandaging. We carried out a systematic review using meta-analysis of selected randomized controlled trials...

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Bibliographic Details
Published in:The Journal of arthroplasty 2015-01, Vol.30 (1), p.31-37
Main Authors: Zan, Pengfei F., MD, Yang, Yong, MD, Fu, Dong, MD, Yu, Xiao, MD, Li, Guodong D., MD
Format: Article
Language:English
Subjects:
Arthritis - surgery
Arthroplasty, Replacement, Knee - adverse effects
Arthroplasty, Replacement, Knee - methods
blood loss
Blood Loss, Surgical - prevention & control
complication
Humans
Knee Joint - surgery
meta-analysis
Orthopedics
Postoperative Hemorrhage - etiology
Postoperative Hemorrhage - prevention & control
Randomized Controlled Trials as Topic
total knee arthroplasty
tourniquet
Tourniquets - adverse effects
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Summary:Abstract The purpose of this study is to examine our hypothesis that releasing tourniquet intraoperatively before wound closure is better than releasing postoperatively after wound closure and bandaging. We carried out a systematic review using meta-analysis of selected randomized controlled trials comparing tourniquet releasing before and after wound closure in TKA. The results showed that tourniquet releasing before wound closure significantly increased the total blood loss ( P < 0.00001), calculated blood loss ( P < 0.0001) as well as postoperative blood loss ( P = 0.007). However, it decreased the risk of both minor ( P = 0.0007) and major complications ( P = 0.05). The available evidence indicated that releasing tourniquet before wound closure for hemostasis increased perioperative blood loss, nevertheless, the risk of complications decreased significantly.
ISSN:0883-5403
1532-8406
DOI:10.1016/j.arth.2014.07.034