Soft-tissue pressures in specimens of the lower extremities of cadavera,
obtained following hip disarticulation, were measured directly beneath a
pneumatic thigh tourniquet to establish the relationship between the
tourniquet pressure and underlying soft-tissue pressure. It was found that
the tissue pressure was consistently lower than the tourniquet pressure and
that the percentage of tourniquet pressure reflected in the underlying
tissue varied inversely with the circumference of the thigh. It was also
found that the pressure decreased with increasing depth of the soft tissue.
Clinical relevance: the use of a pneumatic tourniquet is potentially
associated with injury to underlying muscles, vessels, and nerves if
excessive pressure occurs beneath the tourniquet. In order to minimize the
risk of soft-tissue injury, the lowest tourniquet pressure that maintains a
bloodless field should be used. A nomogram based on data generated in this
experiment is provided as a guide to determining appropriate tourniquet
pressures.