{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,11]],"date-time":"2025-10-11T02:13:04Z","timestamp":1760148784853,"version":"build-2065373602"},"reference-count":24,"publisher":"MDPI AG","issue":"6","license":[{"start":{"date-parts":[[2023,6,10]],"date-time":"2023-06-10T00:00:00Z","timestamp":1686355200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Rapmedicare Co., Ltd."}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JPM"],"abstract":"<jats:p>Sterile silicone ring tourniquets (SSRTs) reduce intraoperative bleeding and provide a wide surgical view. Moreover, they reduce the risk of contamination and are cheaper than conventional pneumatic tourniquets. Our study describes the perioperative outcomes of sterile silicone ring tourniquet placement in pediatric patients undergoing orthopedic surgery. We prospectively recruited 27 pediatric patients aged &lt; 18 years who underwent 30 orthopedic surgeries between March and September 2021. Following complete surgical draping, all operations were initiated by placing SSRTs. We investigated the demographic and clinical characteristics of these patients, details of the tourniquet used, and intra- and postoperative outcomes of tourniquet placement. Owing to the narrowness of tourniquet bands and tourniquet placement at the proximal ends of the extremities, wide surgical fields were achieved, without limiting joint range of motion. Bleeding control was effective. Tourniquets were applied and removed rapidly and safely, regardless of limb circumference. None of the patients experienced postoperative pain, paresthesia, skin problems at the application site, surgical site infections, ischemic problems, or deep vein thrombosis. SSRTs effectively reduced intraoperative blood loss and facilitated wide operative fields in pediatric patients with various limb sizes. These tourniquets allow quick, safe, and effective orthopedic surgery for pediatric patients.<\/jats:p>","DOI":"10.3390\/jpm13060979","type":"journal-article","created":{"date-parts":[[2023,6,12]],"date-time":"2023-06-12T03:02:27Z","timestamp":1686538947000},"page":"979","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["Sterile Silicone Ring Tourniquets in Limb Surgery: A Prospective Clinical Trial in Pediatric Patients Undergoing Orthopedic Surgery"],"prefix":"10.3390","volume":"13","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-5377-9028","authenticated-orcid":false,"given":"Kunhyung","family":"Bae","sequence":"first","affiliation":[{"name":"Department of Orthopedic Surgery, Hanyang University Hospital, Hanyang University College of Medicine, 222 Wangsimni-ro, Seongdong-gu, Seoul 04763, Republic of Korea"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Gisu","family":"Kim","sequence":"additional","affiliation":[{"name":"Department of Orthopedic Surgery, Asan Medical Center Children\u2019s Hospital, University of Ulsan College of Medicine, 88, Olympic-ro, 43-gil, Songpa-gu, Seoul 05505, Republic of Korea"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8709-7404","authenticated-orcid":false,"given":"Amaal M.","family":"Aldosari","sequence":"additional","affiliation":[{"name":"Department of Orthopedic Surgery, Asan Medical Center Children\u2019s Hospital, University of Ulsan College of Medicine, 88, Olympic-ro, 43-gil, Songpa-gu, Seoul 05505, Republic of Korea"},{"name":"Department of Orthopaedic Surgery, Al Noor Specialist Hospital, Makkah 24242, Saudi Arabia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yeonji","family":"Gim","sequence":"additional","affiliation":[{"name":"Department of Orthopedic Surgery, Asan Medical Center Children\u2019s Hospital, University of Ulsan College of Medicine, 88, Olympic-ro, 43-gil, Songpa-gu, Seoul 05505, Republic of Korea"},{"name":"Department of Orthopaedic Surgery, Severance Hospital, Yonsei University College of Medicine, 50-1 Yonsei-ro, Seodaemoon-gu, Seoul 03722, Republic of Korea"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yoon Hae","family":"Kwak","sequence":"additional","affiliation":[{"name":"Department of Orthopedic Surgery, Asan Medical Center Children\u2019s Hospital, University of Ulsan College of Medicine, 88, Olympic-ro, 43-gil, Songpa-gu, Seoul 05505, Republic of Korea"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2023,6,10]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"310","DOI":"10.5435\/00124635-201205000-00007","article-title":"Safe tourniquet use: Are view of the evidence","volume":"20","author":"Fitzgibbons","year":"2012","journal-title":"J. Am. Acad. Orthop. Surg."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"379","DOI":"10.1097\/01202412-200609000-00014","article-title":"A novel elastic exsanguination tourniquet as an alternative to the pneumatic cuff in pediatric orthopedic limb surgery","volume":"15","author":"Eidelman","year":"2006","journal-title":"J. Pediatr. Orthop. B"},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"671","DOI":"10.1097\/01241398-200109000-00023","article-title":"Pediatric tourniquets: Analysis of cuff and limb interface, current practice, and guidelines for use","volume":"21","author":"Tredwell","year":"2001","journal-title":"J. Pediatr. Orthop."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"686","DOI":"10.1177\/107110070002100811","article-title":"Pressure controlled Esmarch bandage used as a tourniquet","volume":"21","author":"Abraham","year":"2000","journal-title":"Foot. Ankle. Int."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"205","DOI":"10.5301\/jva.5000520","article-title":"Narrow elastic disposable tourniquet (Hemaclear\u00ae) vs. traditional wide pneumatic tourniquet for creation or revision of hemodialysis angioaccesses","volume":"17","author":"Bourquelot","year":"2016","journal-title":"J. Vasc. Access."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"59","DOI":"10.1615\/JLongTermEffMedImplants.2018022527","article-title":"Reuse of single-use HemaClear exsanguination tourniquets: A technique note","volume":"27","author":"Franzone","year":"2017","journal-title":"J. Long. Term Eff. Med. Implants"},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"j3423","DOI":"10.1136\/bmj.j3423","article-title":"A growth reference for mid upper arm circumference for age among school age children and adolescents, and validation for mortality: Growth curve construction and longitudinal cohort study","volume":"358","author":"Mramba","year":"2017","journal-title":"BMJ"},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"448","DOI":"10.1097\/PEC.0000000000002770","article-title":"Addition of midthigh circumference improves predictive ability of Broselow tape weight estimation","volume":"38","author":"Saeed","year":"2022","journal-title":"Pediatr. Emerg. Care"},{"doi-asserted-by":"crossref","unstructured":"Latario, L.D., Lubitz, M.G., Narain, A.S., Swart, E.F., and Mortimer, E.S. (2022). Which pediatric supracondylar humerus fractures are high risk for conversion to open reduction?. J. Pediatr. Orthop. B.","key":"ref_9","DOI":"10.1097\/BPB.0000000000001042"},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"548","DOI":"10.1097\/BPO.0000000000001319","article-title":"Outcomes of arthroscopy-assisted closed reduction and percutaneous pinning for a displaced pediatric lateral condylar humeral fracture","volume":"39","author":"Kang","year":"2019","journal-title":"J. Pediatr. Orthop."},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"447","DOI":"10.1007\/s00402-010-1144-x","article-title":"Silicone ring versus pneumatic cuff tourniquet: A comparative quantitative study in healthy individuals","volume":"131","author":"Drosos","year":"2011","journal-title":"Arch. Orthop. Trauma Surg."},{"doi-asserted-by":"crossref","unstructured":"Park, K.K., Cho, B.W., Lee, W.S., and Kwon, H.M. (2023). Silicone ring tourniquet could be a substitute for a conventional tourniquet in total knee arthroplasty with a longer surgical field: A prospective comparative study in simultaneous total knee arthroplasty. BMC Musculoskelet. Disord., 24.","key":"ref_12","DOI":"10.1186\/s12891-023-06469-9"},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"201","DOI":"10.1016\/j.otsr.2010.11.004","article-title":"Minimally-invasive internal fixation of extra-articular distal femur fractures using a locking plate: Tricks of the trade","volume":"97","author":"Ehlinger","year":"2011","journal-title":"Orthop. Traumatol. Surg. Res."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"595","DOI":"10.1016\/j.arth.2014.11.022","article-title":"The Sterile Elastic Exsanguination Tourniquet vs. the Pneumatic Tourniquet for total knee arthroplasty","volume":"30","author":"Brin","year":"2015","journal-title":"J. Arthroplast."},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"2958","DOI":"10.2106\/JBJS.I.00634","article-title":"Surgical tourniquets in orthopaedics","volume":"91","author":"Noordin","year":"2009","journal-title":"J. Bone Jt. Surg. Am."},{"key":"ref_16","first-page":"e5308","article-title":"Microbial colonization of pneumatic tourniquets in the orthopedic operating room","volume":"11","author":"Mufarrih","year":"2019","journal-title":"Cureus"},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"251","DOI":"10.3109\/17453670902930016","article-title":"Tourniquets and exsanguinators: A potential source of infection in the orthopedic operating theater?","volume":"80","author":"Brennan","year":"2009","journal-title":"Acta Orthop."},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"589","DOI":"10.1308\/147870811X13137608455334","article-title":"The effect of sterile versus non-sterile tourniquets on microbiological colonisation in lower limb surgery","volume":"93","author":"Thompson","year":"2011","journal-title":"Ann. R. Coll. Surg. Engl."},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"408","DOI":"10.1186\/s13018-021-02366-w","article-title":"A comparison of thrombosis in total knee arthroplasty with and without a tourniquet: A meta-analysis of randomized controlled trials","volume":"16","author":"Xie","year":"2021","journal-title":"J. Orthop. Surg. Res."},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"545","DOI":"10.1016\/j.jor.2018.05.025","article-title":"Silicone ring tourniquet versus pneumatic cuff tourniquet in total knee arthroplasty surgery: A randomised comparative study","volume":"15","year":"2018","journal-title":"J. Orthop."},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"291","DOI":"10.1016\/j.cjtee.2021.05.002","article-title":"Incidence and factors influencing tourniquet pain","volume":"24","author":"Kamath","year":"2021","journal-title":"Chin. J. Traumatol."},{"key":"ref_22","first-page":"16","article-title":"The effect of the silicone ring tourniquet and standard pneumatic tourniquet on the motor nerve conduction, pain and grip strength in healthy volunteers","volume":"4","author":"Drosos","year":"2016","journal-title":"Arch. Bone Jt. Surg."},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"215","DOI":"10.1177\/1753193410390845","article-title":"Pain and paraesthesia produced by silicone ring and pneumatic tourniquets","volume":"36","author":"Mohan","year":"2011","journal-title":"J. Hand Surg. Eur."},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"136","DOI":"10.70252\/RWVU7100","article-title":"The effect of cuff width for determining limb occlusion pressure: A comparison of blood flow restriction devices","volume":"12","author":"Weatherholt","year":"2019","journal-title":"Int. J. Exerc. Sci."}],"container-title":["Journal of Personalized Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2075-4426\/13\/6\/979\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,10]],"date-time":"2025-10-10T19:52:15Z","timestamp":1760125935000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2075-4426\/13\/6\/979"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,6,10]]},"references-count":24,"journal-issue":{"issue":"6","published-online":{"date-parts":[[2023,6]]}},"alternative-id":["jpm13060979"],"URL":"https:\/\/doi.org\/10.3390\/jpm13060979","relation":{},"ISSN":["2075-4426"],"issn-type":[{"type":"electronic","value":"2075-4426"}],"subject":[],"published":{"date-parts":[[2023,6,10]]}}}