- Total wrist joint replacement
- Replacement of joints in the fingers
- Knee joint replacements
1-4. Expected except group of treatment
- Open fractures of the leg
- Post-traumatic lengthy hand reconstruction
- Severe crushing injuries
- Elbow surgery (where there is excess swelling)
- Severe hypertension
- Skin grafts in which all bleeding points must be readily distinguished
- Compromised vascular circulation, e.g.peripheral artery disease.
- Diabetes mellitus
- The presence of sickle cell disease is a relative contraindication
1-5. Side effect
- A dull aching pain (tourniquet pain) may develop throughout the limb following use.
- Pathophysiologic changes due to pressure, hypoxia, hypercarbia, and acidosis of the
tissues occur and become significant after about one and a half hours of tourniquet use.
- Symptoms of tourniquet paralysis are motor paralysis and loss of sense of touch,
pressure, and proprioceptive responses.
- Intraoperative bleeding may be caused;
By the slight impeding effect exerted by an unpressurized cuff (and its padding, if
used), which prevents venous return at the beginning of the operation.
By blood remaining in the limb because of insufficient exsanguination.
By inadequate tourniquet pressure (between systolic and diastolic blood pressure of
the patient), or slow inflation and deflation, all of which allow arterial blood to enter
while preventing venous return.
By blood entering through the nutrient vessels of the long bones, such as the
humerus.
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