Year 2014 Vol. 22 No 3

EXPERIMENTAL SURGERY

A.P. TRUKHAN

THE ASSESSMENT OF EFFICIENCY OF TOURNIQUET APPLICATION AS A COMPONENT OF THE FIRST AID AT CRUSH SYNDROME. REPORT 1: THE CHANGES OF BIOCHEMICAL PARAMETERS

EE “Belarusian State Medical University”,
The Republic of Belarus

Objectives. To assess the effectiveness of tourniquet application as a component of the first aid in crush syndrome on the basis of blood biochemical parameters.
Methods. The work is based on the experimental modeling a crush syndrome of moderate severity by the method developed by the author (compression is 25 kg/cm2 on the area of 6 cm2 on pelvic limb for 5 hours) in rabbits. In the main group, in contrast with the comparison group, after the removal of compression on the injured limb a tourniquet was applied for 1,5 hours. To estimate the tourniquet influence on local and system changes the 2-fold venous blood sampling for biochemical study has been performed (in 1,5 and 24 hours after the compression removal).
Results. In the first hours after the injury the rapid restoration of blood flow does not occur in the focus of damage. This is confirmed statistically by insignificant differences in the content of potassium (p=0,17), calcium (ð=0,52), C-reactive protein (ð=0,72) 1,5 hours after the compression removal in the main and comparison groups. First of all it is linked to the microcirculation bed blockage due to the traumatic shock. Moreover the tourniquet applying leads to an increasing limb tissue damage, justifying statistically significant difference between the main and comparison groups in C-reactive protein (ð=0,047), urea (ð=0,01) and creatinine (ð=0,00) in a day after the compression removing.
Conclusions. Any objective signs of tourniquet application efficacy to prevent the development of reperfusion-recirculation in crush syndrome have not revealed. Besides the tourniquet application led to the increase of limb tissue damage and increase of trauma shock severity.

Keywords: crush syndrome treatment, application of tourniquet, experimental surgery
p. 280 – 285 of the original issue
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Address for correspondence:
220034, Respublika Belarus, g. Minsk, ul. Azgura, d. 4, Voenno-meditsinskiy fakultet, kafedra voenno-polevoy hirurgii,
e-mail: aleksdoc@yandex.ru,
Trukhan Aleksey Petrovich
Information about the authors:
Trukhan A.P. PhD, an associate professor of the military-field chair of the military-field faculty of EE “BSMU”, lieutenant colonel of medical service.
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