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Tourniquet associated chemical burn.

Yang JH, Lim H, Yoon JR, Jeong HI - Indian J Orthop (2012)

Bottom Line: Chemical burn under pneumatic tourniquet is an iatrogenic preventable injury and is rarely reported in the literature.The two important mechanisms are maceration (friction) and wetness underneath the tourniquent.In this report, our experience with two illustrative patients who presented with iatrogenic tourniquet associated burn is described.

View Article: PubMed Central - PubMed

Affiliation: Department of Orthopedic Surgery, Seoul Veterans Hospital, Korea.

ABSTRACT
Chemical burn under pneumatic tourniquet is an iatrogenic preventable injury and is rarely reported in the literature. The two important mechanisms are maceration (friction) and wetness underneath the tourniquent. In this report, our experience with two illustrative patients who presented with iatrogenic tourniquet associated burn is described.

No MeSH data available.


Related in: MedlinePlus

Case 1. Tourniquet-associated chemical burn developed on medial aspect of thigh: (a) immediate postoperative; (b) 1year and 9 months postoperative
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Figure 1: Case 1. Tourniquet-associated chemical burn developed on medial aspect of thigh: (a) immediate postoperative; (b) 1year and 9 months postoperative

Mentions: A 24 year old male underwent lateral meniscus allograft transplantation on his left knee. The patient did not have thin skin and any underlying skin disease and allergies. The patient's operation was performed under tourniquet control. The tourniquet cuff used was a standard leg tourniquet (18 cm) and was applied with four layers of adequate wool padding. The skin preparation used was a 10% povidone-iodine (betadine) solution. The set pressure was 250 mmHg which was about 100 mmHg higher than the patient's systolic pressure. The tourniquet compression time was 2 h (total operation time=3 h). When the tourniquet was removed after operation, the burn was seen on the medial aspect of thigh [Figure 1a]. While inspecting the padding where the burn was present, the drape preparation seemed to have run down the patient's thigh during painting and had been left in wet condition underneath the tourniquet. The wound was of intermediate to deep second degree burn with blisters of size about 5 × 6 cm. The patient was treated conservatively with a furazone gauze occlusive dressing and was discharged from orthopedic department without skin grafting. However, he underwent multiple treatments with the dermatologist for complete healing which took almost 12 months [Figure 1b]. Even to this time (2 years postoperation), the patient continuously complains of hypersensitivity on the scar area, which aggravates during normal gait.


Tourniquet associated chemical burn.

Yang JH, Lim H, Yoon JR, Jeong HI - Indian J Orthop (2012)

Case 1. Tourniquet-associated chemical burn developed on medial aspect of thigh: (a) immediate postoperative; (b) 1year and 9 months postoperative
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC3377150&req=5

Figure 1: Case 1. Tourniquet-associated chemical burn developed on medial aspect of thigh: (a) immediate postoperative; (b) 1year and 9 months postoperative
Mentions: A 24 year old male underwent lateral meniscus allograft transplantation on his left knee. The patient did not have thin skin and any underlying skin disease and allergies. The patient's operation was performed under tourniquet control. The tourniquet cuff used was a standard leg tourniquet (18 cm) and was applied with four layers of adequate wool padding. The skin preparation used was a 10% povidone-iodine (betadine) solution. The set pressure was 250 mmHg which was about 100 mmHg higher than the patient's systolic pressure. The tourniquet compression time was 2 h (total operation time=3 h). When the tourniquet was removed after operation, the burn was seen on the medial aspect of thigh [Figure 1a]. While inspecting the padding where the burn was present, the drape preparation seemed to have run down the patient's thigh during painting and had been left in wet condition underneath the tourniquet. The wound was of intermediate to deep second degree burn with blisters of size about 5 × 6 cm. The patient was treated conservatively with a furazone gauze occlusive dressing and was discharged from orthopedic department without skin grafting. However, he underwent multiple treatments with the dermatologist for complete healing which took almost 12 months [Figure 1b]. Even to this time (2 years postoperation), the patient continuously complains of hypersensitivity on the scar area, which aggravates during normal gait.

Bottom Line: Chemical burn under pneumatic tourniquet is an iatrogenic preventable injury and is rarely reported in the literature.The two important mechanisms are maceration (friction) and wetness underneath the tourniquent.In this report, our experience with two illustrative patients who presented with iatrogenic tourniquet associated burn is described.

View Article: PubMed Central - PubMed

Affiliation: Department of Orthopedic Surgery, Seoul Veterans Hospital, Korea.

ABSTRACT
Chemical burn under pneumatic tourniquet is an iatrogenic preventable injury and is rarely reported in the literature. The two important mechanisms are maceration (friction) and wetness underneath the tourniquent. In this report, our experience with two illustrative patients who presented with iatrogenic tourniquet associated burn is described.

No MeSH data available.


Related in: MedlinePlus