Abstract
A rolled-up finger from a surgical glove has been described in the literature and commonly used as a tourniquet during procedures on digits. The National Patient Safety Agency (NPSA) issued a rapid response report in December 2009 that recommended the use of CE marked finger tourniquets and prohibited the use of surgical gloves for this purpose. This study aimed to measure the pressures exerted by a range of digital tourniquets.
A Tekscan FlexiForce¯ pressure sensor was used to measure the surface pressures under different types of finger tourniquet applied to a cylinder representing a finger. The tourniquets tested were the Toe-niquet™, the T-Ring™ and a tourniquet made using a rolled up surgical glove finger.
The pressure exerted by these tourniquets varied between types and depended on the size of model finger. The lowest mean pressures were produced by the T-Ring(tm) and glove finger tourniquet on a small finger (146 and 120 mmHg), while the highest pressures were produced by the Toe-niquet(tm), which produced 663 and 1560mmHg on the small and large finger models respectively. There was a significant overall difference between tourniquet type (p<0.001) and finger size (p<0.001).
Wide variability in surface pressures is a function of material type, product design and finger size. It is difficult to anticipate and regulate pressures generated by non-pneumatic tourniquets. Tourniquet safety must also focus on procedural issues, ensuring the removal of the tourniquet at the end of procedure, through increased use of surgical checklists.
