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25 Sep 2021 (Vol 44 , Iss 05 )

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31 Oct 2021 (Vol 44 , Iss 05 )

Journal ID : TMJ-05-08-2021-10544
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Title : Effect of Interval Tourniquet Use on MDA Levels and Liver Histopathological Damage in the Management of Long Bone Fractures

Abstract :

The use of arterial tourniquets as a tool for maintaining hemostasis in trauma has been widely used. The use of tourniquet serves to allow and accelerate operative procedures in musculoskeletal and vascular cases. In addition, torniquet is generally used to aid hemostasis in trauma cases. Providing torniquet perfusion time interval is known to reduce ischemic injury. However, the effect of reperfusion on the MDA level and histopathological damage of the liver has never been identified, thus requiring further research. This study determines the effect of the reperfusion interval in tourniquet use that causes reperfusion ischemic injury on the MDA level and histopathological damage of the liver in the management of long bone fracture. This study employed the true experimental method involving fractured Wistar rats. The Wistar rats were divided into 3 groups, group without reperfusion (P1), group with reperfusion of 10 minutes (P2), and group with reperfusion of 20 minutes. P1 ware treated with a tourniquet without being given a reperfusion interval for 3 hours. The rats in the P2 group were given a tourniquet with a reperfusion interval of 10 minutes after 2 hours. The rats in the P3 group were treated with a tourniquet with a reperfusion interval of 20 minutes after 2 hours of using the tourniquet, then the tourniquet was re-inflated for one hour. After 14 days, the rats were put down and analyzed for their MDA levels and their liver’s histopathological damage. The statistical analysis used one-way ANOVA and Kruskal–Wallis with a significance level of p < 0.05. There was a difference in the reperfusion interval between P1, P2, and P3 groups regarding the MDA levels in the liver (p < 0.05). The reperfusion intervals of 10 and 20 minutes showed a higher reduction of the MDA level in the liver, compared to the group without reperfusion (p <0.05). The reperfusion interval of 20 minutes showed a higher reduction of the MDA levels in the liver compared to P1 group (p < 0.05). There was a difference in the reperfusion interval between the group without reperfusion and the group with reperfusion regarding the liver’s histopathological damage (p < 0.05). The use of reperfusion intervals of 10 and 20 minutes showed a higher reduction of cell ischemia and hepatic necrosis compared to the P1 group. The reperfusion interval of 20 minutes showed a higher reduction of the hepatic cell necrosis compared to the reperfusion interval of 10 minutes (p < 0.05). The reperfusion interval in tourniquet use has an effect on reducing MDA levels and decreasing the number of ischemic and necrosis cells in the liver. There are differences in the duration of the reperfusion interval in the use of tourniquets in preventing ischemic injury.

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