Comparison of Different Tourniquet Release Times in Bunion Surgery

NCT ID: NCT03616847

Last Updated: 2019-05-24

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

UNKNOWN

Clinical Phase

NA

Total Enrollment

80 participants

Study Classification

INTERVENTIONAL

Study Start Date

2018-08-23

Study Completion Date

2021-11-25

Brief Summary

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Patients listed for hallux valgus/hallux rigidus correction surgery will be randomised to one of two treatment groups. Group 1 (standard care) will have the calf tourniquet released after wound closure. Group 2 will have the tourniquet removed five minutes before wound closure. Participants will have the volume of their operated foot measured pre-operatively and post-operatively at six weeks and three months.

Detailed Description

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Pneumatic tourniquets provide the benefits of better visualisation and decreased blood loss, but can also cause metabolic changes due to ischemia and compressive damage due to pressure. Surveys of foot and ankle surgeons demonstrates prevalent use of tourniquets in their clinical practice, with various patterns of use differing amongst the surgeons.

Bunion surgery is one of the most common surgical procedures in foot surgery. It involves correcting the hallux valgus deformity through a combination of various osteotomy, fusion, or soft tissue procedures. Swelling after any surgery is common, but particularly so after foot surgery as gravity causes fluid to collect in the foot. With regards to recovery after surgery, patients are advised to expect to be off work for between 6-8 weeks for a sedentary occupation, and between 12-14 weeks for heavy work. Although patients have low pain levels, the foot remains swollen for an average of 3-6 months after surgery. It is usually the swelling that prevents patients from getting in to normal footwear to be able to return to work sooner.

Bunion surgery is usually performed under a calf-tourniquet to create a bloodless surgical field and ensure less surgical bleeding, thereby reducing surgical time. However, use of tourniquets can lead to more swelling, increased post-operative pain and challenges in rehabilitation - all of which may affect recovery after bunion surgery. Prolonged duration of tourniquet use has been shown to cause post-operative wound healing complications, potentially attributable to local inflammation and tissue hypoxia. It is known from the studies for knee replacement surgery that tourniquet use can lead to decreased range of motion after surgery in early stage.

This study will be a randomised controlled trial with two study groups. The control group will have surgery with the tourniquet remaining in situ until the wound is closed. The intervention group will have the tourniquet released after surgery, but closure will be delayed by five minutes.

Conditions

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Hallux Valgus Hallux Rigidus

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Two randomised study groups with one having standard care and the other the intervention.
Primary Study Purpose

TREATMENT

Blinding Strategy

DOUBLE

Investigators Outcome Assessors
Those collecting and analysis the data will be masked to the treatment groups. It is not possible to mask the participant or the care provider in this study

Study Groups

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Standard care

Participants will have hallux valgus/hallux rigidus surgery using a calf tourniquet which will remain inflated until the wound is closed.

Group Type EXPERIMENTAL

Standard care

Intervention Type OTHER

Hallux valgus/hallux rigidus surgery with the calf tourniquet remaining in situ until the wound is closed.

Tourniquet release

Participants will have hallux valgus/hallux rigidus surgery using a calf tourniquet which will be removed. There will be a five minute delay before the wound is closed.

Group Type EXPERIMENTAL

Tourniquet release

Intervention Type OTHER

Hallux valgus/hallux rigidus surgery with the calf tourniquet released five minutes before the wound is closed.

Interventions

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Standard care

Hallux valgus/hallux rigidus surgery with the calf tourniquet remaining in situ until the wound is closed.

Intervention Type OTHER

Tourniquet release

Hallux valgus/hallux rigidus surgery with the calf tourniquet released five minutes before the wound is closed.

Intervention Type OTHER

Eligibility Criteria

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Inclusion Criteria

* Patients having hallux valgus or hallux rigidus
* Able to give informed consent
* Able to return for follow-up

Exclusion Criteria

* Patients with symptomatic peripheral vascular disease
* Patients with known peripheral oedema from any cause
* Patients who will also require lesser toe correction as part of the procedure
* Active smokers
Minimum Eligible Age

18 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Golden Jubilee National Hospital

OTHER_GOV

Sponsor Role lead

Responsible Party

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Responsibility Role SPONSOR

Principal Investigators

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Kalpesh Shah, M.D.

Role: PRINCIPAL_INVESTIGATOR

Gloden Jubilee National Hospital

Locations

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Golden Jubilee National Hospital

Clydebank, West Dunbartonshire, United Kingdom

Site Status RECRUITING

Countries

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United Kingdom

Central Contacts

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Alistair M Ewen, Ph. D.

Role: CONTACT

0141 951 5946

Kathryn Macpherson, B. Sc.

Role: CONTACT

0141 951 5121

Facility Contacts

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Alistair M Ewen, PhD

Role: primary

0141 951 5946

Kathryn Macpherson, BSc

Role: backup

0141 951 5121

Other Identifiers

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18/ORTH/03

Identifier Type: -

Identifier Source: org_study_id

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