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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

Suggested method for tourniquet application with elastic stockinette and wool padding. Note the adhesive plaster (black arrow) (a) and antimicrobial incise drape (white arrow) (b) used for mechanical barrier
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Figure 3: Suggested method for tourniquet application with elastic stockinette and wool padding. Note the adhesive plaster (black arrow) (a) and antimicrobial incise drape (white arrow) (b) used for mechanical barrier

Mentions: To prevent tourniquet associated chemical burn, two important points should be noted. First, friction between the skin and the tourniquet should be avoided because macerated skin becomes more permeable to PI which may become prone for damage. Movement of tourniquet during draping and compression should also be prevented. An elastic stockinette is known to be effective in preventing the development of maceration induced blisters.22 The shape mismatch between the tourniquet and the thigh should be considered when applying tourniquet to minimize friction. Very muscular or obese patients tend to have conical shaped thigh.14 Even distribution moving the skin and the soft tissues distally underneath the tourniquet may overcome this mismatch. Second, emphasis should be made on some form of barrier occluding the tourniquet, preventing wool soaking from antiseptics.1516 In addition to a number of commercial covers, a variety of simple, non commercial alternatives have been proposed. Sarkhel and Stride15 suggested using the disposable reservoir bag from a single use anesthetic circuit, while the use of surgical glove was proposed by Tomlinson and Harries.16 Our department has been using adhesive plaster (Sinsin Pharm Co. Ltd., Korea) and antimicrobial incise drape (Ioban™ 2®, 3M Health care, USA) for mechanical barrier [Figure 3a and b]. On taking these precautions, further occurrence of tourniquet associated chemical burns was prevented.


Tourniquet associated chemical burn.

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

Suggested method for tourniquet application with elastic stockinette and wool padding. Note the adhesive plaster (black arrow) (a) and antimicrobial incise drape (white arrow) (b) used for mechanical barrier
© Copyright Policy - open-access
Related In: Results  -  Collection

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

Figure 3: Suggested method for tourniquet application with elastic stockinette and wool padding. Note the adhesive plaster (black arrow) (a) and antimicrobial incise drape (white arrow) (b) used for mechanical barrier
Mentions: To prevent tourniquet associated chemical burn, two important points should be noted. First, friction between the skin and the tourniquet should be avoided because macerated skin becomes more permeable to PI which may become prone for damage. Movement of tourniquet during draping and compression should also be prevented. An elastic stockinette is known to be effective in preventing the development of maceration induced blisters.22 The shape mismatch between the tourniquet and the thigh should be considered when applying tourniquet to minimize friction. Very muscular or obese patients tend to have conical shaped thigh.14 Even distribution moving the skin and the soft tissues distally underneath the tourniquet may overcome this mismatch. Second, emphasis should be made on some form of barrier occluding the tourniquet, preventing wool soaking from antiseptics.1516 In addition to a number of commercial covers, a variety of simple, non commercial alternatives have been proposed. Sarkhel and Stride15 suggested using the disposable reservoir bag from a single use anesthetic circuit, while the use of surgical glove was proposed by Tomlinson and Harries.16 Our department has been using adhesive plaster (Sinsin Pharm Co. Ltd., Korea) and antimicrobial incise drape (Ioban™ 2®, 3M Health care, USA) for mechanical barrier [Figure 3a and b]. On taking these precautions, further occurrence of tourniquet associated chemical burns was prevented.

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