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Sensory changes with prolonged double-cuff tourniquet time in hand surgery
1Department of Orthopaedic Surgery, Massachusetts General Hospital, Harvard Medical School, Boston.
The Journal of Hand Surgery
|September 1, 1988
Summary
The double-cuff tourniquet technique safely extends surgical time up to 4 hours, with most patients regaining normal hand sensation within weeks. This method preserves nerve function and patient comfort during prolonged hand operations.
Area of Science:
- Orthopedic Surgery
- Neurosurgery
- Hand Surgery
Background:
- Tourniquet use in hand surgery is limited by potential nerve damage.
- Prolonged tourniquet times can cause sensory deficits.
- The double-cuff tourniquet technique aims to mitigate these risks.
Purpose of the Study:
- To evaluate sensory changes in the operated hand after using the double-cuff tourniquet technique for up to 4 hours.
- To assess the safety and efficacy of prolonged tourniquet application in hand surgery.
Main Methods:
- Thirty patients undergoing hand operations exceeding 2 hours were enrolled.
- Sensory tests (light touch, von Frey, vibration, two-point discrimination) were performed.
- Subjective sensation and postoperative edema were assessed pre- and post-operatively.
Main Results:
- 73% of patients achieved normal sensory test results within 23 days.
- 80% reported equal subjective sensation in operated vs. non-operated hands within 1 week.
- 96% ultimately demonstrated normal sensory function and subjective sensation.
- Postoperative edema occurred in 53% and resolved within 4 weeks.
Conclusions:
- The double-cuff tourniquet technique is safe for tourniquet times up to 4 hours.
- It allows for prolonged hand surgeries with minimal long-term sensory impairment.
- Nerve function recovery is generally rapid and complete.