Background
The Rotherham NHS Foundation Trust in South Yorkshire is a combined acute and community Trust providing services to a population of more than 260,000 people.
Delivering both elective and trauma surgery, Rotherham District General Hospital has a team of Consultant Orthopaedic surgeons specialising in hand and wrist surgery.
For certain procedures, the use of a tourniquet is essential to maintain a bloodless field for the duration of the surgery, and the aim is always to use the lowest possible occlusion pressure to sustain this throughout the operation to minimise tissue damage.
Equipment
Rotherham Hospital has a suite of eight operating theatres and included in its inventory of devices are five AT4 Electronic Tourniquet Systems supplied by British designer and manufacturer of clinical equipment, Anetic Aid.
The company, which is also Yorkshire based, has been supplying tourniquets for more than 40 years, but the AT4 was launched as recently as 2013, following extensive consultations between practitioners and the company's design team.
While there have been a number of refinements since, the key principle of an independent device, operating from its own integral air supply (so no need for air supply hoses, medical air cylinders or power leads) remains as a crucial design feature. While the inflation is not as instantaneous as in a traditional piped air service driven pneumatic tourniquet, the AT4 still inflates within the required six seconds, and in combination with a slower deflation capability, is generally considered to be less damaging for tissue.
Engineered to be compact, lightweight and robust, the tourniquet's sensitive leak compensation facilities, as well as automatic self-diagnostic checks on start-up, combine to offer maximum safety and reliability.
A regular user of the AT4 is Mr Alex Kocheta, who is both a Consultant Surgeon at the hospital and is also the Trust's Associate Medical Director for Medical Education.
He explained: 'You obviously want the lowest possible limb occlusion pressure to maintain the bloodless field as this means less tissue damage for the patient, and I noticed this was something we were able to achieve with the Anetic Aid machine. In general, I would say the pressures could be 10% to 15% lower - and the slow inflation / deflation capability is better for tissue too.
'I have also been impressed by the long-life battery which means the machine doesn't have to be plugged in during a procedure in theatre — there are more than enough wires around in that environment, so one less is always helpful!'
Mr Kocheta's work includes a wide range of procedures from complex rheumatoid reconstruction and arthroplasty to fractures and arthroscopies.
'The fact that the AT4 has two channels also means we can use one machine for bilateral procedures, perhaps a case involving a fall which has left someone with two broken wrists. This is good for the patient in terms of minimising the duration of their procedures and their time under anaesthetic, but is also an extremely efficient use of theatre time offering the facility for two surgeons to operate simultaneously.'
Rotherham also uses other Anetic Aid equipment including the QA4 Mobile Surgery System and Lift-assist Stirrups.
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