Tourniquets are commonly used in podiatric surgery to provide hemostasis and a bloodless surgical field. Complications from tourniquet are most frequently attributed to tourniquet use outside the recommended time or pressure setting and can cause muscle, nerve, and vascular injury. The mechanism of the injuries is secondary to ischemia and compression which can cause significant damage to tissues. It is accepted that a tourniquet used in foot surgery should be deflated at the 120-minute mark and that a rest period of 15 minutes needs to occur prior to reinflation of the tourniquet. In addition, it is recommended that there be additional deflation with 10-minute rest times at every subsequent 30-minute period for which the tourniquet is inflated. These standards were created to prevent complications associated with long periods of ischemia from prolonged tourniquet times.
Tourniquets in Podiatric Surgery