Abstract
The objective of this paper is to raise the awareness of a possible fatal complication
during operations in the lower limbs, when an Esmarch bandage is used for exsanguination
of the affected limb during the operation. After reviewing the literature, four cases
of fatal massive pulmonary embolism have been identified after Esmarch bandage application
in trauma patients [Acta Anaesthesiol Belg 50(2) (1999) 95, Reg. Anaesth 6 (1983)
83, Anesthesiology 58 (1983) 373, Anaesthesia 25(3) (1970) 445] but there is no any
reference to an elective case. The authors would like to report two cases of fatal
embolism after Esmarch bandage application for both elective surgery (total knee replacement)
and trauma (trimalleolar fracture). Both patients had received regional anaesthesia.
After comparing the data from our cases and the literature, it is recommended that
the Esmarch bandage should not be used in trauma, especially when there has been a
delay in time for surgery. In elective cases of the lower limbs, preoperative cardiovascular
evaluation and the exclusion of other factors predisposing to DVT are necessary, especially
for patients more than 50 years old.
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Article info
Publication history
Accepted:
April 18,
2002
Footnotes
☆Financial disclosure statement: No benefits in any form have been received or will be received from a commercial party related directly or indirectly to the subject of this article.
Identification
Copyright
© 2002 Elsevier Science Ltd. Published by Elsevier Inc. All rights reserved.
