We performed a prospective randomized clinical study to determine
whether use of a thigh tourniquet influences the incidence of deep venous
thrombosis. The lower limbs of patients who were scheduled for elective
surgery on the fore part of the foot were randomized and assigned to one of
three treatment categories: Group I, no tourniquet; Group II,
exsanguination by an Esmarch bandage before tourniquet application; and
Group III, exsanguination by elevation of the extremity prior to
application of a tourniquet. The 117 limbs of seventy-one patients included
in this study were evaluated preoperatively and twenty-four and seventy-two
hours postoperatively with 125I-labeled fibrinogen, and preoperatively and
seventy-two hours postoperatively with Doppler ultrasound studies and
phleborheography. The findings in all of the Doppler ultrasound studies and
all of the phleborheograms were normal. Two of the 125I-fibrinogen studies
were positive, but subsequent contrast venography revealed that these were
false-positive findings. We therefore concluded that the use of a thigh
tourniquet does not increase the risk of deep venous thrombosis in patients
who have had an operation on the fore part of the foot.