Chaudhary S, Koshy C, Ahmed J, et al
Friction Burns to Thigh Caused by Tourniquet
Br J Plast Surg 51: 142-143, 1998
Although skin damage is rare with the use of a pneumatic tourniquet, a case of friction burns in a healthy individual with normal skin is reported.
A man, aged 48, having a second stage total knee replacement after his infected prothesis was removed, was fitted with a standard thigh cuff of 11 by 92 cms, with a wool padding and sealed off with adhesive surgical drape. Skin was prepared with aqueous chlorhexidine. The tourniquet was inflated to 300 mm Hg for 2 hours and 13 minutes. After the procedure, the tourniquet was seen to have overrun the wool padding by about half its width to be in contact with the skin. On the next day, the patient had circumferential blisters where the tourniquet had contact with the skin. The blisters grew into full thickness burns by day 3. The wound was infected and two weeks later, the skin was debrided and partial thickness skin graft applied. The graft took and the patient was discharged after 5 days.
It is concluded by the authors that the tourniquet slipped either because it was not tied tightly enough before inflation or slipped due to vigourous operative manipulations and the conical shape of the thigh, resulting in full thickness skin burns at the point of contact of the slipped tourniquet.