The Use of HemaClear Tourniquet in Pediatric Orthopedic Surgery – Is It Really Safe?

Introduction: The objective of a tourniquet in surgery is to provide a bloodless surgical field; in order to reduce bleeding, identify anatomical structures and as a consequence reduce length of surgery and the need for blood products. In children the use of the tourniquet is as common as in adults, but there are factors that preclude the use of the standard pneumatic tourniquet – the limb is shorter and the conical shape of the thigh may cause sliding of the tourniquet distally. HemaClear is made of a silicon ring wrapped with a sterile stockinet sleeve. It is placed on the operated limb and then rolled proximally, exsanguinating the distal limb and stopping the circulation distal to the silicone ring.
The aim of this study was to investigate the safety and efficiency of the HemaClear Tourniquet in a large population in pediatric orthopedic surgery.

Materials and Methods: A retrospective cohort of 1075 children (0-18 years) that were operated in our department during the years 2006-2014, with the use of HemaClear tourniquet during surgery.

Results: The average tourniquet time was 40 minutes. In all patients the HemaClear tourniquet was found to be effective in keeping a bloodless surgical field. No skin, vascular or neurological complications were noted after surgery.

Conclusions: To the best of our knowledge this is the largest cohort study examining the safety of the HemaClear tourniquet. The HemaClear was found to be safe and highly efficient for use in all examined extremity surgeries in the pediatric population.