A Survey of Tourniquet Use in Limbs Surgery among the Orthopaedic Surgeons of Peshawar

Aim: To assess the orthopaedic surgeons knowledge and technique on tourniquet use in clinical practice in Peshawar. Methods: This Descriptive case series study was conducted in Orthopaedic and Trauma Unit "A" Lady Reading Hospital Peshawar from February 2014 to July 2014. Fifty orthopaedic surgeons of Peshawar with varying levels of experience in Orthopaedics & Trauma surgery were given a questionnaire that was constructed using set guidelines from the Association of peri operative Registered Nurses (AORN) for recommended practice of tourniquet application in the United States. Results: A total of 44 completed questionnaires were collected for analysis of which 34(77.2%) respondents were reported using pneumatic tourniquet, 6(13.6%) Esmarch bandage while, 4(9%) using no tourniquet at all. Limb occlusion pressure (LOP) or systolic blood pressure had not been utilized by any surgeon to calculate the tourniquet inflation pressure. Mean utes (range, 45-100 minutes) for the upper limb and 95 minutes for the lower limb. Fourteen surgeons (41.1% of respondents) using pneumatic tourniquet and four surgeons using rubber tourniquet experienced a complication secondary to tourniquet use, the most common complications being tourniquet pain and nerve injury. Conclusion: Our results show suboptimal knowledge of tourniquets and their use among the orthopaedic surgeons of Peshawar. A variation in tourniquet pressure settings and techniques used was reported.