Surgical hemostasis by pneumatic ankle tourniquet during 3027 podiatric operations

A retrospective study was performed at the Denver Doctors Hospitals in which 3818 surgical cases on the foot and/or ankle were reviewed over a 4-year period from July 1986 through May 1990. From the 3027 ankle tourniquet cases reviewed, it was determined that pneumatic ankle tourniquets are safe and effective in providing hemostasis during foot surgery. There were five postoperative complications noted with ankle cuffs, with post-tourniquet syndrome being the most common (three cases). Over the 4-year period, ankle tourniquets failed a total of 50 times, a 1.8% failure rate (0.25% failure rate in the last 17 months). The most common pressure setting used for ankle cuffs was 325 mm. Hg (400 mm. Hg for thigh cuffs). Tourniquet ischemia lasted from 4 to 139 min.; the most common duration of ischemia noted for ankle tourniquets was 30 to 60 min. (60 to 90 min. for thigh tourniquets). A review of the potential complications associated with tourniquets, as well as safeguards, recommendations, and contraindications are presented.