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MEDICINA E CHIRURGIA DELLA CAVIGLIA E DEL PIEDE
A Journal on Physiopathology and Surgery of the Foot
Indexed/Abstracted in: EMBASE, Scopus
Chirurgia Del Piede 2005 September;29(3):127-36
Mechanical effects of haemostatic tourniquet compression in leg surgery
Napoli V., Napoli E.
The compression exerted by haemostatic tourniquet, routinely used in the absence of contraindications in leg surgery, is accompained by mechanical, haemodynamic and metabolic effects that directly involve the underlying tissues. These effects lead to a variation in their homeostasis, the extent and reversibility of which is related to the extent and duration of ischaemic compression. Control of the mechanical effects on tissues and of the variations induced requires respect for certain indispensable rules for controlling the use of the haemostatic tourniquet. The configuration of the tourniquet must fit in with the conformation of the leg. In normal conditions its width varies between 10 and 15 cm. The best place to position the tourniquet is at the root of the thigh or third of the leg where the abundant presence of connective muscle tissue offers most protection. The level of compression must be related to tissue pressure that can normally be estimated at between 100 and 150 mm Hg and to systolic arterial pressure averaging 100-150 mmHg to which a tolerance of 25% is added to cover possible fluctuations. the duration of compression must not exceed 120 minutes.