A NEW TECHNIQUE FOR HEMODIALYSIS ACCESS SURGERY - USE OF THE PNEUMATIC TOURNIQUET

The purpose of this study was to determine whether tourniquet occlusio n could be safely used on the upper extremity for vascular control dur ing hemodialysis access surgery. The hospital and outpatient records o f 44 patients undergoing 105 hemodialysis access procedures were retro spectively reviewed. In 48 procedures tourniquet occlusion was used fo r vascular control, whereas in 57 procedures vascular clamps were used . In those procedures in which the tourniquet was used, the mean tourn iquet time was 30 minutes and the mean tourniquet pressure was 242 mm Hg. The operative time was significantly less in the tourniquet group as compared to the clamp group (72.5 minutes vs. 84 minutes, respectiv ely; p = 0.029). There was no statistically significant difference in the incidence of nerve injury, bleeding, hematoma, vascular steal, inf ection, or swelling between the two groups. There were no complication s related specifically to the use of the tourniquet. There was no diff erence in primary patency in comparing the tourniquet control group wi th the clamp control group (p >0.5). The use of a pneumatic tourniquet for vascular control during hemodialysis access surgery allows for a faster, technically easier operation with no increase in the complicat ion rate and no effect on primary patency.