The Clinical Research On Tourniquet And Non-tourniquet Use On Free Fibular Flap Preparation

Objective:comparative study between tourniquet and non-tourniquet use on free fibula flap preparation.Patients and Methods: We performed a retrospective analysis of 40 patients who underwent free fibular flap transplantation for oral and maxillofacial reconstruction between October 2016 to December 2018.There were 20 women and 20 men.These patients were randomly divided into two groups with tourniquet and without tourniquet.Patients were evaluated by the(a)Amount of bleeding(b)The lower extremity drainage vol.(c)Incisional skin paresthesia(d)Operation time for fibula bone preparation and(e)Recovery time.All patients signed an informed consent form.Statistical analyses of the results were obtained by using window based computer software devised with Statistical Packages for Social Sciences(SPSS-22).Results: The mean age was 41.85±17.43 years in tourniquet used and 37.05±19.05 years in tourniquet not used.More than half(55.0%)patients were male in tourniquet used and 9(45.0%)in tourniquet not used.The mean BMI was 21.3±2.0 kg/m2 in tourniquet used and 20.9±2.1 kg/m2 in tourniquet not used.More than three fourth(80.0%)patients had left surgical side in tourniquet used and 18(90.0%)in tourniquet not used.The mean the length of the fibula cut was 13.1±3.1 cm in tourniquet used and11.7±2.4 cm in tourniquet not used.The difference was statistically not significant(p>0.05)between two groups.The mean time of cutting the fibula was 73±12 min in tourniquet used and 91±13 min in tourniquet not used.The mean the amount of bleeding was 80±7 ml in tourniquet used and 109±15 ml in tourniquet not used.The mean lower extremity drainage volume was 178±42 ml in tourniquet used and 180±45 ml in tourniquet not used.The difference of operation time and the amount were statistically significant(p<0.05)between two groups.Lower limb pain found 2(12.5%)and 3(20.0%)in tourniquet used and tourniquet not used respectively.Almost one third(31.25%)patients had incisional skin paresthesia in tourniquet used and 5(33.33%)in tourniquet not used.The difference was statistically not significant(p>0.05)between two groups.Regarding the compression between operation time with tourniquet/ band of the study populations it was observed that 17 cases used tourniquet/band in ≤80 minutes operation time and 3 cases in > 80 minutes operation time.The difference was statistically significant(p<0.05)between two groups.Conclusion: In this study,the application of tourniquet can shorten the operation time of free fibular flap and reduce bleeding during surgery.At minimum one year follow up there is no significant impact on the recovery of lower limb function and incisional skin paresthesia.