Timing of Tourniquet Release: A Prospective Randomized Trial

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.

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.