Abstract
Introduction: There are no guidelines for the use of any particular tourniquet in foot surgery. We undertook this prospective randomised study to assess the efficacy of the S-MART TM tourniquet in foot surgery as compared to the pneumatic tourniquet. A literature review confirms this is the first randomised controlled study objectively measuring the outcomes of this tourniquet system.
Material and Methods: We included 40 consecutive patients who had foot surgery from May 2006 to August 2006. Informed consent with local medical ethics committee approval was obtained. We excluded patients with history of diabetes mellitus, deep vein thrombosis, fractures, limb circumference more than 40 centimetres and smokers. The ease of application of tourniquet, intraoperative bloodless field and ease of removal was scored on a scale of 1–10. Patients were followed up at 2 weeks.
Results: 20 patients were randomised into group one with pneumatic tourniquet (average age 63.36) and 20 patients in group two with S-MART TM tourniquet (average age 61.25). The average tourniquet placement time in-group one was 144.36 seconds as compared to 12 seconds ingroup two. The mean ease of application scores was 4.27 in-group one as compared to 1.46 in-group two. Total tourniquet time was more in-group one. Intraoperative haemostasis was rated higher in-group two.
Discussion: SMART TM tourniquet provides a good intraoperative haemostasis and is easy to apply. This tourniquet helps to exsanguinate; this frees up theatre personnel, saves resources and decreases tourniquet time for surgery.
The limitation is it cannot be reinflated and cannot be used in patients with fractures.
Conclusion: S-MART tourniquet is a good for foot surgery, provides a good operative field, is easy to apply and saves precious theatre time and resources.
Correspondence should be addressed to: D. Singh, BOFAS, c/o BOA, The Royal College of Surgeons, 35–43 Lincoln’s Inn Fields, London WC2A 3PE.
