A survey of the use of tourniquet among orthopaedic surgeons in Nigeria

Background: The modern arterial tourniquet is an automatic tourniquet system which contains many features that help to minimise complications and improve safety. However, the non-pneumatic tourniquet is still in use, a practice that may be commoner in resource-constrained settings. This study was conducted to investigate the types of tourniquet available and used by orthopaedic surgeons in Nigeria as well as the practical aspects and complications of their use of the tourniquet. Materials and Methods: At an Annual General Meeting/Scientific Conference of Nigerian Orthopaedic Association, a survey was conducted among orthopaedic surgeons using a pre-tested self-administered questionnaire which contained questions on types of tourniquet, practical aspects of the use of tourniquet and complications. Results: The non-pneumatic tourniquet was usually used by 60.2% of the respondents and 58.1% of those who had both pneumatic and non-pneumatic tourniquets used the latter more commonly. In most cases, the tourniquet was applied by surgeons or surgical residents on the arm or thigh. Surgeons who had ever used the tourniquet in diabetic patients were 71.6% while 29.5% had used it in patients with sickle cell disease. Tourniquet duration was usually 11/2 h and 2 h in the upper and lower limbs, respectively. The two most common complications were tourniquet palsy and tourniquet pain. Conclusions: The non-pneumatic tourniquet was more commonly used than the pneumatic tourniquet. Application of the tourniquet on sites other than the thigh and the upper arm were uncommon. The most common complication was neurologic injury.