Abstract
Background
This study aims to explore the effectiveness of one-per-mil tumescent technique in hand surgery, which involves bone and joint.
Methods
This is a case series study on 14 patients with 15 operative fields. One-per-mil solution is formulated by mixing 0.05 mL of 1:1,000 epinephrine and 100 mg lidocaine in 50-mL saline solution. The solution was injected subcutaneously into the operative area until the skin turned pale. The surgery started 7–10 min after the last injection. We classified the operative field clarity into four categories: totally bloodless, minimum bleeding, acceptable bleeding, and bloody operative field. We also recorded the amount of tumescent solution, top-ups needed, length of surgery, type of anesthesia, and intraoperative pain reported by the patients under local anesthesia.
Results
Five patients were operated on under local anesthesia while the other ten were under general anesthesia. Eight cases yielded totally bloodless operative fields, while seven were classified as acceptable bleeding. There were no top-ups and conversion of anesthesia needed during surgery.
Conclusions
We consider one-per-mil tumescent technique as a promising successor of pneumatic tourniquet in bone and joint surgery, especially for lengthy procedures on hand and upper extremity.
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Conflict of Interest
Theddeus O.H. Prasetyono declares that he has no conflict of interest.
Debby K.A. Saputra declares that she has no conflict of interest.
Windi Astriana declares that she has no conflict of interest.
Statement of Human Rights
We warrant that all procedures in this study were in accordance with the ethical standards of the responsible committee on human experimentation (institutional and national) and with the Helsinki Declaration of 1975, as revised in 2008(5).
Statement of Informed Consent
All subjects provided written informed consent as well as photo and video release consent prior to the procedure.
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Prasetyono, T.O.H., Saputra, D.K.A. & Astriana, W. One-per-mil tumescent technique for bone and joint surgery in hand. HAND 10, 123–127 (2015). https://doi.org/10.1007/s11552-014-9661-7
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DOI: https://doi.org/10.1007/s11552-014-9661-7