Fat Embolism: The Prophylactic Value of a Tourniquet

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As a result of a method of detecting fat droplets in the circulating blood, it has been possible to make a study of fat embolism in 100 patients undergoing elective orthopaedic surgery. The results of this study have been correlated with the results obtained in experiments on animals. By these investigations it has been demonstrated: (1) that fat embolism is more frequently associated with operations upon the bone than with operations upon the soft tissues; (2) that the use of a tourniquet in an operation upon bone effectively sequesters fat in the extremity and prevents fat droplets from reaching the systemic circulation; and (3) that the compression of the soft tissues by a tourniquet produces a minor degree of fat embolism.A tourniquet should be used whenever possible in operative procedures involving trauma to bone because of its value in minimizing fat embolism.

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