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The Effect of Hyperoxygenated Fatty Acids in Preventing Skin Lesions Caused by Surgical Pneumatic Tourniquets

Castillo Martín, Beatriz; Castillo Martín, Juan Ignacio MD; Lago Oliver, Jesús; Diz Gómez, Jorge

Advances in Skin & Wound Care: May 2018 - Volume 31 - Issue 5 - p 214–217
doi: 10.1097/01.ASW.0000530065.52255.5d

OBJECTIVES: To determine whether hyperoxygenated fatty acids (HOFAs) provide safe and effective protection against lesions caused by surgical pneumatic tourniquets (SPTs).

METHODS: This was a nonrandomized, single-blind, 2-arm, prospective, comparative study. The study was approved by the Ethics and Clinical Research Commission of the Hospital Universitario Gregorio Marañón, in Madrid, Spain. Subjects in the intervention group were treated topically with HOFAs (Linovera; B. Braun Medical Inc, Bethlehem, Pennsylvania) at the site (upper and lower limbs) where an SPT was to be applied. An elastic bandage was then set in place and finally the SPT. Control subjects were treated in the same way, but no HOFAs were applied.

PARTICIPANTS: The study subjects were all patients of the Department of Orthopedic and Trauma Surgery at the Hospital Universitario Gregorio Marañón for whom the use of an SPT was indicated for 60 minutes or longer. In total, 174 patients completed the study, 83 in the HOFA-treatment arm and 91 in the control arm. All subjects gave their informed consent to be included.

MAIN OUTCOME: Assessment of the lesions induced by the SPT after its removal.

MAIN RESULTS: Significant correlations were found between the risk of developing lesions and age 70 years or older (P = .021), a duration of ischemia of 70 minutes or longer (P = .006), and being a member of the control group (P < .001). Some 93.4% of the intervention group experienced only a grade 0 to 1 skin lesion compared with 55.4% of the control group. Moreover, 44.6% of the control arm subjects suffered a grade 2 to 4 lesion compared with only 6% of the HOFA-treated subjects. No subject in the treatment arm suffered any important skin lesion; in the control arm, however, 2 patients suffered edema, another suffered induration, and 2 experienced abrasions.

CONCLUSIONS: The use of topical HOFAs, in conjunction with the application of an elastic bandage before applying an SPT, is a safe and effective way of preventing SPT-induced skin lesions.

In Madrid, Spain, Beatriz Castillo Martín is Associate Professor, Faculty of Nursing, Physiotherapy, and Podiatry, Universidad Complutense de Madrid, and Nurse, Hospital Universitario Gregorio Marañón; Juan Ignacio Castillo Martín, MD, is Associate Professor, Faculty of Medicine, Universidad Complutense de Madrid, and Head of Physical Medicine and Rehabilitation, Hospital 12 de Octubre; Jesús Lago Oliver is Associate Professor, Department of Surgery, Universidad del Rey Juan Carlos de Madrid, and Specialist, General and Digestive Surgery, Hospital Universitario Gregorio Marañón; and Jorge Diz Gómez is Director, Faculty of Nursing, Physiotherapy, and Podiatry, Universidad Complutense de Madrid.

The authors have disclosed no other financial relationships related to this article.

Submitted February 24, 2017; accepted in revised form September 11, 2017.

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