TY - JOUR
T1 - A single center retrospective review of hair tourniquet syndrome and a proposed treatment algorithm
AU - Bean, Jonathan F.
AU - Hebal, Ferdynand
AU - Hunter, Catherine J.
N1 - Publisher Copyright:
© 2015 Elsevier Inc. All rights reserved.
PY - 2015/9/1
Y1 - 2015/9/1
N2 - Introduction Hair tourniquet syndrome (HTS) is a rare disorder characterized by a hair becoming tightly wound around an appendage. There is little known about the epidemiology, optimal treatment, or indications for surgical intervention in HTS. We hypothesized that HTS could be readily diagnosed and treated in the pediatric emergency department and we sought out factors predictive of surgical intervention. Methods We performed a single center retrospective review of all patients who presented with a hair tourniquet from May 2004 till March 2014. Results Eighty-one patients were diagnosed with HTS, ranging in age from 2 weeks to 22 years. Of these patients, 69 were located on the toes, 5 on fingers, and 7 on genitalia. The average ages for each location were statistically different (p < 0.0001). Ninety-four percent of patients were successfully treated by nonoperative means. Cellulitis was found in two patients. Tissue necrosis occurred in one patient. Conclusion HTS is an uncommon disorder and location differs with age. Chemical depilatory agents should be a first line treatment for this condition in most patients. If chemical tourniquet release fails, then the patient should undergo mechanical tourniquet release. If edema, erythema and pain fail to resolve after tourniquet release, then persistent hair tourniquet should be investigated.
AB - Introduction Hair tourniquet syndrome (HTS) is a rare disorder characterized by a hair becoming tightly wound around an appendage. There is little known about the epidemiology, optimal treatment, or indications for surgical intervention in HTS. We hypothesized that HTS could be readily diagnosed and treated in the pediatric emergency department and we sought out factors predictive of surgical intervention. Methods We performed a single center retrospective review of all patients who presented with a hair tourniquet from May 2004 till March 2014. Results Eighty-one patients were diagnosed with HTS, ranging in age from 2 weeks to 22 years. Of these patients, 69 were located on the toes, 5 on fingers, and 7 on genitalia. The average ages for each location were statistically different (p < 0.0001). Ninety-four percent of patients were successfully treated by nonoperative means. Cellulitis was found in two patients. Tissue necrosis occurred in one patient. Conclusion HTS is an uncommon disorder and location differs with age. Chemical depilatory agents should be a first line treatment for this condition in most patients. If chemical tourniquet release fails, then the patient should undergo mechanical tourniquet release. If edema, erythema and pain fail to resolve after tourniquet release, then persistent hair tourniquet should be investigated.
KW - Complications
KW - Key words Hair tourniquet
KW - Pediatric
KW - Treatment
UR - http://www.scopus.com/inward/record.url?scp=84942551978&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=84942551978&partnerID=8YFLogxK
U2 - 10.1016/j.jpedsurg.2014.11.041
DO - 10.1016/j.jpedsurg.2014.11.041
M3 - Article
C2 - 25783322
AN - SCOPUS:84942551978
SN - 0022-3468
VL - 50
SP - 1583
EP - 1585
JO - Journal of pediatric surgery
JF - Journal of pediatric surgery
IS - 9
ER -