Leprosy
Mailing List – March 1st, 2010
Ref.: Tourniquet
use in upper and lower extremity surgery
From: Antonio
Salafia,
Mumbai
,
India
Dear
Salvatore,
I would like to add my comments on the on-going discussion about
tourniquet at its contraindications/side effects.
As you know I am a trained hand-surgeon.
1.
In
Legnano
,
Italy
, where I trained under Prof. Morelli, we had an average of 40
major cases a day, in almost all cases a tourniquet was
used.
2.
I
have been following Prof. Morelli's teachings in all patients:
leprosy and non-leprosy cases.
3.
I
have operated a few hundred non leprosy patients (trauma,
congenital) and more then 7000 leprosy cases.
In
all the cases I have used the tourniquet, and so far, I have
never had any compression/strangulation of nerves or any of the other
side effects mentioned. I must add that
when I operated on a nerve (be it the ulnar, the median or any other)
I do not use a tourniquet except in a very few cases; most of the time
there is no need; good hemostasis is all that it is required. Faulty
technique, poor training are the reasons for these problems in most of
the cases.
Dr. Antonio Salafia
Head
of Dpt. Reconstructive Surgery
Vimala
Dermatological Centre
Mumbai
,
India
