• A J Hodgson.
• Mechanical Engineering Department, University of British Columbia, Vancouver, Canada.
• Biomed Instrum Technol. 1993 Sep 1;27(5):401-7.

AbstractPneumatic tourniquets are routinely used in limb surgery to provide a bloodless operating field, but they are known to cause nerve injuries. Simulation results based on the hypothesis that axial compression of nerves is responsible for a certain class of these mechanically induced injuries are in substantial accord with clinical observations. A model of the limb and tourniquet that treats the tissue as a linearly elastic solid is presented and is used to predict the induced axial strains. The smallest axial strains are induced by a tourniquet design for which the applied pressure distribution rolls off as gradually as possible; according to the axial-strain hypothesis, such a design will markedly decrease a tourniquet's inherent potential for injury. Use of a wider cuff in and of itself will not reduce axial strain, so if the hypothesis is correct, a wider cuff would not be intrinsically safer than a regular cuff, a result that is contrary to current opinion.

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