Variability in local pressures under digital tourniquets

Area of Science:

• Medical Devices
• Biomedical Engineering
• Patient Safety

Background:

• Complications from digital tourniquet use and retention prompted safety warnings.
• Guidance recommends CE-marked tourniquets and discourages surgical gloves.
• Limited data exists on the comparative properties, efficacy, and safety of non-pneumatic digital tourniquets.

Purpose of the Study:

• To investigate the variability of pressures exerted by non-pneumatic digital tourniquets.
• To compare the physical properties of different digital tourniquet devices.

Main Methods:

• Utilized a Tekscan FlexiForce sensor to measure applied force and surface pressures.
• Tested Toe-niquet™, T-Ring™, and surgical glove 'roll down' tourniquets on finger models.
• Analyzed pressure variations based on tourniquet type and finger size.

Main Results:

• Significant differences in pressure were observed between tourniquet types (p<0.001) and finger sizes (p<0.001).
• Toe-niquet™ produced the highest mean pressure (1560 mmHg).
• Larger surgical glove sizes (size 8) produced the lowest mean pressure (25 mmHg).

Conclusions:

• Anticipating and regulating pressures from non-pneumatic tourniquets is challenging.
• Defining safe application times and surface pressures is difficult.
• Further research is required to model pressure effects and identify safe, effective digital tourniquets.