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Updated: May 11, 2026

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Timing of Tourniquet Release: A Prospective Randomized Trial.

Warren Williams1, Thomas Hays1, Brendan Kosko1

  • 1Orlando Health Jewett Orthopedic Institute, FL, USA.

Hand (New York, N.Y.)
|May 10, 2026
PubMed
Summary

Tourniquet release timing in upper extremity surgery does not impact patient outcomes. Releasing the tourniquet before or after skin closure yielded similar results for pain and function.

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Area of Science:

  • Orthopedic Surgery
  • Surgical Techniques
  • Patient Outcomes

Background:

  • Tourniquet use is common in upper extremity surgery, but optimal release timing is debated.
  • Limited research exists on tourniquet release timing and its effect on patient outcomes in upper extremity procedures.

Purpose of the Study:

  • To investigate whether tourniquet release before or after incision closure affects clinical outcomes in upper extremity surgeries.

Main Methods:

  • A prospective randomized trial involving 214 patients undergoing upper extremity surgery.
  • Patients were divided into two groups: tourniquet release before incision closure versus after closure.
  • Outcomes measured included complications, Visual Analogue Scale (VAS) pain scores, and Quick Disabilities of the Arm, Shoulder, and Hand (QuickDASH) scores.
Keywords:
handtiming of tourniquet releasetourniquettourniquet releaseupper extremity

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Main Results:

  • 172 patients completed follow-up; 91 released tourniquet before closure, 81 after.
  • No significant differences in demographic data or intraoperative/immediate postoperative complications between groups.
  • Follow-up data showed similar VAS pain scores and QuickDASH scores for both tourniquet release timing groups.

Conclusions:

  • Releasing the tourniquet after surgical incision closure results in comparable clinical outcomes to releasing it prior to closure in upper extremity surgery.
  • Visual analog pain scores and QuickDASH scores were similar regardless of tourniquet release timing.
  • Surgeons can consider releasing the tourniquet either before or after incision closure based on preference and operative circumstances.