A prospective study of 100 cases of sterile T-RING™ digital tourniquet application

The ideal finger tourniquet must be easy to use and provide a completely bloodless field with control of the pressure exerted at the compression site. The primary objective of this study was to evaluate the effectiveness of the T-RING™ digital tourniquet in emergency hand surgery; the secondary objective was to define the optimal indications and possible contraindications. This prospective study, undertaken between May 4 and July 30, 2015, comprised the application of 100 finger tourniquets in the following indications: all single or multiple digital wounds, distal from the base of the proximal phalanx, irrespective of their nature and the suspected structural damage. Data were collected with a questionnaire at the end of each surgical use of the finger tourniquet. An overall grade out of 30 was obtained by combining these scores. The facility of opening the packing was rated on average at 4/4, the facility of applying the finger tourniquet was rated at 3.8/4, the quality of the exsanguination at the beginning and at the end of the procedure were rated at 3.4/4 and 3.1/4, respectively, the difficulty related to positioning of the finger tourniquet was rated at 2.7/3, the facility of removing the finger tourniquet was rated at 3.6/4, the risk of forgetting the finger tourniquet at the end of the procedure was rated to 2.8/3, the comparison with an arm tourniquet was rated at 1.9/4. The overall grade was 25.1/30 on average. In current practice, use of the T-Ring™ tourniquet did not cause any difficulty. The tourniquet was never forgotten and the risk of forgetting it was considered low by the surgeons. The exsanguination appeared satisfactory, with a reduction in its effectiveness over time. We identified specific situations where its use could be indispensable: contraindication to trunk or plexus regional anesthesia, or as a relay to a pneumatic arm tourniquet after more than 2hours.