tourniquets

Summary

Summary: Devices for the compression of a blood vessel by application around an extremity to control the circulation and prevent the flow of blood to or from the distal area. (From Dorland, 28th ed)

Top Publications

  1. Reikeras O, Clementsen T. Time course of thrombosis and fibrinolysis in total knee arthroplasty with tourniquet application. Local versus systemic activations. J Thromb Thrombolysis. 2009;28:425-8 pubmed publisher
    ..Systemic activations in thrombosis and fibrinolysis start when local mediators from the injured limb are released after tourniquet deflation. ..
  2. Guo J, Liu Y, Ma Y, Pi H, Wang J. Evaluation of emergency tourniquets for prehospital use in China. Chin J Traumatol. 2011;14:151-5 pubmed
    Massive hemorrhage is life-threatening during armed conflicts. Tourniquets are important medical devices used to reduce severe bleeding in trauma...
  3. Younger A, Manzary M, Wing K, Stothers K. Automated cuff occlusion pressure effect on quality of operative fields in foot and ankle surgery: a randomized prospective study. Foot Ankle Int. 2011;32:239-43 pubmed publisher
    ..LOP measurement was a practical way of setting tourniquet pressures for limb surgery. The automated pressure averages were lower than those routinely used by most surgeons for thigh tourniquets.
  4. Tai T, Lin C, Jou I, Chang C, Lai K, Yang C. Tourniquet use in total knee arthroplasty: a meta-analysis. Knee Surg Sports Traumatol Arthrosc. 2011;19:1121-30 pubmed publisher
    ..The current evidence suggested that using tourniquet in TKA may save time but may not reduce the blood loss. Due to the higher risks of thromboembolic complications, we should use a tourniquet in TKA with caution. ..
  5. Steffin B, Green Riviere E, Giori N. Timing of tourniquet release in total knee arthroplasty when using a postoperative blood salvage drain. J Arthroplasty. 2009;24:539-42 pubmed publisher
    ..We conclude that the use of a blood salvage drain should not influence the surgeon's preference on timing of tourniquet release in total knee arthroplasty. ..
  6. Estebe J, Davies J, Richebe P. The pneumatic tourniquet: mechanical, ischaemia-reperfusion and systemic effects. Eur J Anaesthesiol. 2011;28:404-11 pubmed publisher
  7. Selvan D, Harle D, Fischer J. Beware of finger tourniquets: a case report and update by the National Patient Safety Agency. Acta Orthop Belg. 2011;77:15-7 pubmed
    Finger tourniquets have been used in finger surgery for a long time to provide a bloodless field while operating on digits...
  8. Kragh J. Use of tourniquets and their effects on limb function in the modern combat environment. Foot Ankle Clin. 2010;15:23-40 pubmed publisher
    b>Tourniquets have been called powerful lifesaving devices by some authors, whereas others say they cause more harm than good...
  9. Kragh J, Walters T, Baer D, Fox C, Wade C, Salinas J, et al. Practical use of emergency tourniquets to stop bleeding in major limb trauma. J Trauma. 2008;64:S38-49; discussion S49-50 pubmed publisher
    Previously we showed that tourniquets were lifesaving devices in the current war. Few studies, however, describe their actual morbidity in combat casualties. The purpose of this study was to measure tourniquet use and complications...

More Information

Publications62

  1. Thorey F, Stukenborg Colsman C, Windhagen H, Wirth C. The effect of tourniquet release timing on perioperative blood loss in simultaneous bilateral cemented total knee arthroplasty: a prospective randomized study. Technol Health Care. 2008;16:85-92 pubmed
    ..Therefore, we recommend a tourniquet release after wound closure to reduce the duration of TKA procedure and to avoid possible risks of extended anaesthesia. ..
  2. Li B, Wen Y, Wu H, Qian Q, Lin X, Zhao H. The effect of tourniquet use on hidden blood loss in total knee arthroplasty. Int Orthop. 2009;33:1263-8 pubmed publisher
    ..Our results indicate that knee arthroplasty operations with a tourniquet might promote postoperative hidden blood loss and hinder patients' in early postoperative rehabilitation exercises. ..
  3. Jacob A, Mantilla C, Sviggum H, Schroeder D, Pagnano M, Hebl J. Perioperative nerve injury after total knee arthroplasty: regional anesthesia risk during a 20-year cohort study. Anesthesiology. 2011;114:311-7 pubmed publisher
    ..However, in rare situations when PNI occurs, complete recovery may be less likely if it develops after peripheral nerve blockade. ..
  4. Smith T, Hing C. A meta-analysis of tourniquet assisted arthroscopic knee surgery. Knee. 2009;16:317-21 pubmed publisher
    ..There is limited evidence to suggest that a tourniquet assists in arthroscopic knee surgery. The methodological quality of the present evidence-base remains weak. Further study is required to answer this research question. ..
  5. Naim S, Srinivasan M. Digital tourniquets: a comparative analysis of pressures and pain perception. Acta Orthop Belg. 2008;74:195-9 pubmed
    Digital tourniquets have been condemned because of the reported occurrence of neurovascular complications...
  6. Ishii Y, Noguchi H, Matsuda Y, Takeda M, Higashihara T. A new tourniquet system that determines pressures in synchrony with systolic blood pressure. Arch Orthop Trauma Surg. 2008;128:297-300 pubmed
  7. Beekley A, Sebesta J, Blackbourne L, Herbert G, Kauvar D, Baer D, et al. Prehospital tourniquet use in Operation Iraqi Freedom: effect on hemorrhage control and outcomes. J Trauma. 2008;64:S28-37; discussion S37 pubmed publisher
    ..Among 3,444 total admissions, 165 patients met inclusion criteria. Sixty-seven patients had prehospital tourniquets (TK); 98 patients had severe extremity injuries but no prehospital tourniquet (No TK)...
  8. Fitzgibbons P, DiGiovanni C, Hares S, Akelman E. Safe tourniquet use: a review of the evidence. J Am Acad Orthop Surg. 2012;20:310-9 pubmed publisher
    ..However, simple principles and general guidelines regarding tourniquet use can be extrapolated to guide safe practice. ..
  9. Mowafi H, Ismail S. Melatonin improves tourniquet tolerance and enhances postoperative analgesia in patients receiving intravenous regional anesthesia. Anesth Analg. 2008;107:1422-6 pubmed publisher
    ..3+/-27.5 mg vs 116.3+/-38.3 mg, P=0.007) compared with the control group. Melatonin is an effective premedication before IVRA since it reduced patient anxiety, decreased tourniquet-related pain, and improved perioperative analgesia. ..
  10. Wright D, Barbagiovanni S, Swan B, Swan K. Tourniquets revisited. J Trauma. 2009;66:672-5 pubmed publisher
    ..so called "Pressure Points?" To address these questions, we measured the effects of three common tourniquets on arterial pulses (Doppler signals) at wrist and ankle of 10 healthy adult volunteers of either sex...
  11. Olivecrona C, Ponzer S, Hamberg P, Blomfeldt R. Lower tourniquet cuff pressure reduces postoperative wound complications after total knee arthroplasty: a randomized controlled study of 164 patients. J Bone Joint Surg Am. 2012;94:2216-21 pubmed publisher
    ..An important secondary finding was that patients with a cuff pressure of ?225 mm Hg had no postoperative infections and a lower rate of wound complications. ..
  12. Al Shabibi N, Chapman L, Madari S, Papadimitriou A, Papalampros P, Magos A. Prospective randomised trial comparing gonadotrophin-releasing hormone analogues with triple tourniquets at open myomectomy. BJOG. 2009;116:681-7 pubmed publisher
    To compare intra-operative blood loss with triple tourniquets to occlude uterine blood supply against preoperative treatment with gonadotrophin-releasing hormone (GnRH) analogues at open myomectomy.
  13. Smith T, Hing C. The efficacy of the tourniquet in foot and ankle surgery? A systematic review and meta-analysis. Foot Ankle Surg. 2010;16:3-8 pubmed publisher
    b>Tourniquets are commonly used during foot and ankle surgery. The purpose of this study was to compare the peri- and post-operative outcomes of tourniquet-assisted to non-tourniquet-assisted ankle and foot surgery...
  14. Schoen M, Rotter R, Gierer P, Gradl G, Strauss U, Jonas L, et al. Ischemic preconditioning prevents skeletal muscle tissue injury, but not nerve lesion upon tourniquet-induced ischemia. J Trauma. 2007;63:788-97 pubmed
    ..High susceptibility of the peripheral nerve to compression-induced ischemic injury disproves IPC in its clinical application for surgical procedures requiring prolonged tourniquet ischemia. ..
  15. Walters T, Kragh J, Kauvar D, Baer D. The combined influence of hemorrhage and tourniquet application on the recovery of muscle function in rats. J Orthop Trauma. 2008;22:47-51 pubmed publisher
    ..For +H animals, tourniquets were applied at the conclusion of blood withdrawal...
  16. Doyle G, Taillac P. Tourniquets: a review of current use with proposals for expanded prehospital use. Prehosp Emerg Care. 2008;12:241-56 pubmed publisher
    The use of arterial tourniquets in prehospital emergency care has been fraught with controversy and superstition for many years despite the potential utility of these tools...
  17. Cox E, Cohen E, Mellecker C, Raw R, Fraser A, Williams G, et al. Intraoperative femoral nerve stimulation in evaluation of patellar tracking: tourniquet effects and catheter placement. Iowa Orthop J. 2010;30:104-8 pubmed
    ..0330). Increased tourniquet inflation times require greater stimulus amplitude to generate quadriceps muscle contraction. Ultrasound guidance for catheter placement can provide femoral nerve stimulation at low amplitudes. ..
  18. Smith T, Hing C. Is a tourniquet beneficial in total knee replacement surgery? A meta-analysis and systematic review. Knee. 2010;17:141-7 pubmed publisher
    Proponents of tourniquets postulate that they optimise intra-operative visibility and reduce blood loss. This study compared the outcomes of tourniquet assisted to non-tourniquet assisted total knee replacement (TKR)...
  19. Norman D, Greenfield I, Ghrayeb N, Peled E, Dayan L. Use of a new exsanguination tourniquet in internal fixation of distal radius fractures. Tech Hand Up Extrem Surg. 2009;13:173-5 pubmed publisher
    ..No side effects or complications were noted. In our opinion, the fact that HemaClear/40 is a sterile, single-patient device makes it superior over the traditional technology. ..
  20. Mohan A, Baskaradas A, Solan M, Magnussen P. Pain and paraesthesia produced by silicone ring and pneumatic tourniquets. J Hand Surg Eur Vol. 2011;36:215-8 pubmed publisher
    ..After application of the tourniquets, the pain and paraesthesia experienced by the participants was scored at 1?minute, 5?minutes, and 10?minutes...
  21. Lima Oliveira G, Lippi G, Salvagno G, Montagnana M, Scartezini M, Guidi G, et al. Transillumination: a new tool to eliminate the impact of venous stasis during the procedure for the collection of diagnostic blood specimens for routine haematological testing. Int J Lab Hematol. 2011;33:457-62 pubmed publisher
    ..As such, considering that inappropriate use of the tourniquet is commonplace, we conclude that transillumination devices can represent a suitable tool to eliminate the venous stasis and to improve the quality of phlebotomy procedures. ..
  22. Alcelik I, Pollock R, Sukeik M, Bettany Saltikov J, Armstrong P, Fismer P. A comparison of outcomes with and without a tourniquet in total knee arthroplasty: a systematic review and meta-analysis of randomized controlled trials. J Arthroplasty. 2012;27:331-40 pubmed publisher
    ..Minor complications were more common in the tourniquet group. The remaining outcomes showed no difference between the groups. Using a tourniquet may be beneficial, but long-term studies of outcome are needed. ..
  23. Tran T, Tu H, Pipinos I, Muelleman R, Albadawi H, Li Y. Tourniquet-induced acute ischemia-reperfusion injury in mouse skeletal muscles: Involvement of superoxide. Eur J Pharmacol. 2011;650:328-34 pubmed publisher
    ..In the future, this murine ischemia-reperfusion model can be adapted to mechanistically evaluate anti-ischemic molecules in tourniquet-induced skeletal muscle injury. ..
  24. Yasuda T, Fujita S, Ogasawara R, Sato Y, Abe T. Effects of low-intensity bench press training with restricted arm muscle blood flow on chest muscle hypertrophy: a pilot study. Clin Physiol Funct Imaging. 2010;30:338-43 pubmed publisher
    ..There were no changes in baseline concentrations of anabolic hormones in either group. These results suggest that BFR bench press training leads to significant increases in muscle size for upper arm and chest muscles and 1-RM strength. ..
  25. Noordin S, McEwen J, Kragh J, Eisen A, Masri B. Surgical tourniquets in orthopaedics. J Bone Joint Surg Am. 2009;91:2958-67 pubmed publisher
    ..Selective use of pneumatic, wider, and contoured tourniquet cuffs reduces tourniquet pressure levels and the applied pressure gradients. ..
  26. Ishii Y, Noguchi H, Takeda M. Clinical use of a new tourniquet system for foot and ankle surgery. Int Orthop. 2010;34:355-9 pubmed publisher
    ..tourniquet should be applied at the lowest pressure possible for maintaining a bloodless surgical field, the new system appears to be practical and reasonable, as compared to conventional tourniquets, which maintain the initial pressure.
  27. Sato J, Ishii Y, Noguchi H, Takeda M. Safety and efficacy of a new tourniquet system. BMC Surg. 2012;12:17 pubmed publisher
    ..The system reduces labor needed to deflate and re-inflate to achieve different pressures. It also seemed to contribute to the safety in upper limb surgery, in spite of rare unexpected oozing mid-surgery, by reducing tissue pressure. ..
  28. Drosos G, Stavropoulos N, Kazakos K, Tripsianis G, Ververidis A, Verettas D. Silicone ring versus pneumatic cuff tourniquet: a comparative quantitative study in healthy individuals. Arch Orthop Trauma Surg. 2011;131:447-54 pubmed publisher
    ..Both tourniquets were applied in the arm and thigh of 15 healthy unmedicated volunteers...
  29. Brennan S, Walls R, Smyth E, Al Mulla T, O Byrne J. Tourniquets and exsanguinators: a potential source of infection in the orthopedic operating theater?. Acta Orthop. 2009;80:251-5 pubmed publisher
    Fomites are increasingly being recognised as a source of hospital-acquired infection. We have therefore assessed tourniquets and exsanguinators for the presence of bacterial pathogens in 1 elective and 2 trauma orthopedic hospitals...
  30. Vandenbussche E, Duranthon L, Couturier M, Pidhorz L, Augereau B. The effect of tourniquet use in total knee arthroplasty. Int Orthop. 2002;26:306-9 pubmed
    ..Knee arthroplasty operations without the use of a tourniquet cause a greater blood loss but have only small benefits in the early post-operative period. ..
  31. Delgado Martinez A. Pneumatic tourniquets in extremity surgery. J Am Acad Orthop Surg. 2002;10:232; author reply 232 pubmed
  32. Graham B, Breault M, McEwen J, McGraw R. Perineural pressures under the pneumatic tourniquet in the upper extremity. J Hand Surg Br. 1992;17:262-6 pubmed
    ..The distribution of these forces is one which may subject the underlying nerves to deleterious shear forces, especially at higher levels of inflation. ..
  33. Clarke M, Longstaff L, Edwards D, Rushton N. Tourniquet-induced wound hypoxia after total knee replacement. J Bone Joint Surg Br. 2001;83:40-4 pubmed
    ..Use of a tourniquet during TKR can increase postoperative wound hypoxia, especially when inflated to high pressures. Our findings may be relevant to wound healing and the development of wound infection. ..
  34. Wauke K, Nagashima M, Kato N, Ogawa R, Yoshino S. Comparative study between thromboembolism and total knee arthroplasty with or without tourniquet in rheumatoid arthritis patients. Arch Orthop Trauma Surg. 2002;122:442-6 pubmed
    ..In the without-tourniquet group, none of these conditions was noted. These results suggest that the use of a tourniquet will promote the risk of developing postoperative PE and/or DVT after total knee arthroplasty. ..
  35. Crawford R, Hashmi F, Jones J, Albadawi H, McCormack M, Eberlin K, et al. A novel model of acute murine hindlimb ischemia. Am J Physiol Heart Circ Physiol. 2007;292:H830-7 pubmed
    ..In conclusions, ORB produced similar levels of tissue ischemia in murine models of limb I/R with fewer levels of nonspecific injury. ORB may be the preferred model for selected studies of limb I/R. ..
  36. Fellowes C, Kerstein R, Clark J, Azadian B. MRSA on tourniquets and keyboards. J Hosp Infect. 2006;64:86-8 pubmed
  37. Walters T, Wenke J, Kauvar D, McManus J, Holcomb J, Baer D. Effectiveness of self-applied tourniquets in human volunteers. Prehosp Emerg Care. 2005;9:416-22 pubmed
    b>Tourniquets are not commonly used in routine extremity trauma, but can be vital for hemorrhage control in austere conditions...
  38. Leitch A, McCormick I, Gunn I, Gillespie T. Reducing the potential for phlebotomy tourniquets to act as a reservoir for meticillin-resistant Staphylococcus aureus. J Hosp Infect. 2006;63:428-31 pubmed
    The contamination rate of phlebotomy tourniquets with meticillin-resistant Staphylococcus aureus (MRSA) was assessed, and it was determined whether this could be reduced by changes in practice or by the use of a physical barrier...
  39. Komatsu T, Ishibashi Y, Otsuka H, Nagao A, Toh S. The effect of surgical approaches and tourniquet application on patellofemoral tracking in total knee arthroplasty. J Arthroplasty. 2003;18:308-12 pubmed
    ..However, in the midvastus approach, LRT was significantly decreased after tourniquet deflation. We concluded that both the parapatellar and midvastus approaches influence patellar tracking and LRT. ..
  40. Levy O, David Y, Heim M, Eldar I, Chetrit A, Engel J. Minimal tourniquet pressure to maintain arterial closure in upper limb surgery. J Hand Surg Br. 1993;18:204-6 pubmed
    ..2 mmHg, well below the 250 to 300 mmHg previously recommended. The technique consisted of inflating the tourniquet to a pressure of 300 mmHg, then reducing it to the calculated value. A bloodless field was maintained in all patients. ..
  41. Sacar S, Turgut H, Kaleli I, Cevahir N, Asan A, Sacar M, et al. Poor hospital infection control practice in hand hygiene, glove utilization, and usage of tourniquets. Am J Infect Control. 2006;34:606-9 pubmed
    ..of this study is to attract attention on poor hospital infection control practice in venepuncture and use of tourniquets and emphasize the importance of hand hygiene...
  42. Kam P, Kavanagh R, Yoong F, Kavanaugh R. The arterial tourniquet: pathophysiological consequences and anaesthetic implications. Anaesthesia. 2001;56:534-45 pubmed
    ..Systemic effects are related to the inflation or deflation of the tourniquet. Safe working guidelines for the application of an arterial tourniquet have not been clearly defined. ..
  43. Sheth N, Sennett B, Berns J. Rhabdomyolysis and acute renal failure following arthroscopic knee surgery in a college football player taking creatine supplements. Clin Nephrol. 2006;65:134-7 pubmed
  44. Horlocker T, Hebl J, Gali B, Jankowski C, Burkle C, Berry D, et al. Anesthetic, patient, and surgical risk factors for neurologic complications after prolonged total tourniquet time during total knee arthroplasty. Anesth Analg. 2006;102:950-5 pubmed
    ..048). We conclude that the likelihood of neurologic dysfunction increases with total tourniquet time and that a reperfusion interval only modestly decreases the risk of nerve injury. ..
  45. Taylor A, Sharma M, Tsirkas P, Di Spiezio Sardo A, Setchell M, Magos A. Reducing blood loss at open myomectomy using triple tourniquets: a randomised controlled trial. BJOG. 2005;112:340-5 pubmed
    To evaluate triple tourniquets in controlled conditions and for the first time to investigate the hypothesis that leaving a semi-permanent tourniquet around the uterine artery reduces post-operative bleeding from the uterine incisions...
  46. Lakstein D, Blumenfeld A, Sokolov T, Lin G, Bssorai R, Lynn M, et al. Tourniquets for hemorrhage control on the battlefield: a 4-year accumulated experience. J Trauma. 2003;54:S221-5 pubmed
    ..Of 550 soldiers who were treated in the prehospital setting, tourniquets were applied to 91 (16%) patients and in less than 15 minutes in 88% of the cases with almost no complications...
  47. Kato N, Nakanishi K, Yoshino S, Ogawa R. Abnormal echogenic findings detected by transesophageal echocardiography and cardiorespiratory impairment during total knee arthroplasty with tourniquet. Anesthesiology. 2002;97:1123-8 pubmed
    ..This prospective study showed that embolic events occurred during total knee arthroplasty, even while a tourniquet was inflated. An inflated tourniquet does not completely prevent pulmonary emboli. ..
  48. Kutty S, McElwain J. Padding under tourniquets in tourniquet controlled surgery: Bruner's ten rules revisited. Injury. 2002;33:75 pubmed
  49. Husum H, Gilbert M, Wisborg T, Pillgram Larsen J. Prehospital tourniquets: there should be no controversy. J Trauma. 2004;56:214-5 pubmed
  50. Tibrewal S. The pneumatic tourniquet in arthroscopic surgery of the knee. Int Orthop. 2001;24:347-9 pubmed
    ..The study suggests that the use of a tourniquet in arthroscopic surgery of the knee is unnecessary. ..
  51. Fukuda A, Hasegawa M, Kato K, Shi D, Sudo A, Uchida A. Effect of tourniquet application on deep vein thrombosis after total knee arthroplasty. Arch Orthop Trauma Surg. 2007;127:671-5 pubmed
    There is a great deal of controversy about the effect of tourniquets on development of deep vein thrombosis (DVT) after total knee arthroplasty (TKA)...
  52. Navein J, Coupland R, Dunn R. The tourniquet controversy. J Trauma. 2003;54:S219-20 pubmed
  53. Lippi G, Salvagno G, Montagnana M, Franchini M, Guidi G. Venous stasis and routine hematologic testing. Clin Lab Haematol. 2006;28:332-7 pubmed