Introduction

What is a tourniquet? A tourniquet can be defined as a constricting or compressing device used to control arterial and venous blood flow to a portion of an extremity for a period of time. Pressure is applied circumferentially around a portion of a limb at a desired location; this pressure is transferred to the walls [...]

What are Internal Tourniquets?

A recent US patent for an ‘internal tourniquet for surgery’ [1] described innovation that opens the door to extending tourniquet-related concepts to surgical procedures not previously amenable to conventional tourniquets, especially procedures near truncal-extremity junctions, including hip and shoulder regions, and in the deep abdomen. Synergies exist by integrating this internal tourniquet innovation with related [...]

Tourniquets for Treating Open Fractures and Traumatic Injuries: Contraindicated or Not?

Overview: A current overview of the use of tourniquets in surgery and traumatic injury is provided elsewhere [1]. Open fractures: The use of a tourniquet is contraindicated in the surgical treatment of open limb injuries because it is necessary to make an assessment of the devascularized zone of injury for the purpose of wound management [...]

Tourniquet Cuff Technology

What is the purpose of a tourniquet cuff? The purpose of a tourniquet cuff is to safely stop or restrict arterial blood flow into a portion of an extremity by applying a uniform circumferential pressure around the extremity at a desired location. Pneumatic tourniquet cuffs In general, a pneumatic tourniquet cuff is composed of an [...]

Tourniquet Cuff Selection

In the United States, pneumatic tourniquet cuffs are regulated as Class I medical device by the Food and Drug Administration (FDA). Risks of injuries to patients and legal liability for users arise from use of a pneumatic tourniquet cuff not meeting the FDA requirements. Therefore, it is important to only use pneumatic tourniquet cuffs that [...]

Tourniquet Cuff Application

Applying the Tourniquet After the patient is brought into the OR, apply the tourniquet at the desired location on the limb, pressurized within the appropriate pressure range for an appropriate period of time. The following sections provide a general sequence of events for preparation, cuff application and setting up the tourniquet instrument (Note: This sequence [...]

Personalized Scalp Tourniquets

Alopecia (hair loss) is a common consequence of cancer treatment known to have a profound impact on quality of life.  Tourniquet technologies have been investigated from the mid-1960s to early 1980s as a strategy for preventing chemotherapy-induced alopecia (CIA) but their ambiguous results precluded incorporation into any standard of treatment [1].  Fundamental advances inherent in [...]

Personalized Blood Flow Restriction (BFR) Rehabilitation

Why is it crucial to use personalized restriction pressures in blood flow restriction (BFR) rehabilitation? Problems in current BFR rehabilitation practice Blood Flow Restriction (BFR) applied to a limb during low intensity exercise has been shown to increase muscle size and strength across different age groups.  However, a review of BFR rehabilitation literature shows that inconsistencies [...]

Personalized BFR Rehabilitation for Patients with Possible Prior Nerve Injury

A question was raised recently as to whether it is safe and reasonable to conduct personalized BFR rehabilitation on a patient who may have a prior nerve injury.  After consideration of the evidence-based clinical literature, and in consultation with experts in neurology and orthopedic/arthroscopic surgery, the following information is provided in response: There is no [...]

Pediatric Tourniquets

Pediatric patients are different from adult patients in that they have smaller limb circumferences and limb lengths, different mass of muscle and other soft tissues, and different physiological characteristics such as blood pressures and heart rate. These characteristics can vary greatly within the pediatric population from neonatal to adolescent patients. To ensure safe and effective [...]