Abstract
Anterior ankle incisions and tourniquet use in foot and ankle surgery have both been
associated with increased incidence of incisional healing complications. Although
a tourniquet is commonly used for procedures such as total ankle replacement and ankle
arthrodesis that utilize an anterior ankle incision, it is possible to avoid tourniquet
use while preserving adequate visualization with atraumatic layered dissection and
closure, appropriate use of electrocautery, and ligation of vessels as needed. The
primary aim of this study is to report rates of anterior ankle incisional healing
complications both with and without tourniquet use. A retrospective chart review was
performed on consecutive patients undergoing total ankle replacement or ankle arthrodesis
through a multi-provider foot and ankle surgery practice between 2013 and 2018. A
total of 121 patients, 58 (47.9%) in the tourniquet group and 63 (52.1%) in the no-tourniquet
group, were included in this study with a median follow-up period of 36 (range 2-96)
months. There was a higher rate of incisional healing complications for the tourniquet
group (5.2%) compared to the no-tourniquet group (3.2%), however this did not reach
statistical significance (p = .670). There was no significant difference in operative time between the tourniquet
and no-tourniquet group (p = .405). The overall incisional healing complication rate was 4.1%. Although avoiding
tourniquet use alone does not appear to significantly reduce anterior ankle incisional
healing complications, the described technique has yielded an overall lower rate of
incisional complications compared to those commonly reported in the literature.
Level of Clinical Evidence
Keywords
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Article info
Publication history
Published online: August 14, 2022
Footnotes
Conflicts of Interest: Dr. Blacklidge is a consultant for Paragon28, Novastep, Extremity Medical; Dr. Miller is a consultant for Flower Orthopedics; Dr. Elliott is a consultant for Stryker and DJO.
Financial Disclosure: None reported.
Identification
Copyright
© 2022 by the American College of Foot and Ankle Surgeons. All rights reserved.
