Using the Boazul cuff to reduce blood loss in varicose vein surgery

Abstract

Objectives: This study was designed to assess if the use of a sterile exsanguination tourniquet (Boazul cuff) reduced blood loss from the groin and avulsion wounds during varicose vein surgery, (saphenofemoral disconnection, stripping to knee and multiple avulsions). Design: Prospective, parallel cohort study. Materials: Thirty-eight patients undergoing primary varicose vein surgery. Methods: The blood loss and number of avulsion wounds were recorded for each patient. Results: The tourniquet was used on 21 legs and there were 24 legs in the non-tourniquet group. In the tourniquet group, the median blood loss from the groin was 15 ml, (range 5-70 ml), and from the leg was 5 ml, (range 0-120 ml). The corresponding figures for the group without the tourniquet were a median of 17.5 ml, (range 5-105 ml), and a median of 95 ml, (range 10-505 ml). The mean number of avulsions in the tourniquet group was 25 (range 9-38), and in the non-tourniquet group was 15, (range 5-40). There was significantly less blood loss from the leg in the tourniquet group (p<0.0001) despite the fact that there were more avulsions in the tourniquet group (p<0.001). Conclusions: Use of the Boazul cuff significantly decreases the blood loss from the avulsion sites during routine varicose vein surgery, and may encourage the surgeon to perform more avulsions.