Surgery>>>>>Surgery of the Hand and Wrist
Question 1#

For vascular injuries to the hand requiring tourniquet, the maximum time the tourniquet should be applied to prevent tissue necrosis is:

a. 1 hour
b. 2 hours
c. 3 hours
d. 4 hours

Correct Answer is B

Comment:

Initial treatment for an actively bleeding wound should be direct local pressure for not less than 10 continuous minutes. If this is unsuccessful, an upper extremity tourniquet inflated to 100 mm Hg above the systolic pressure should be used. One should keep this tourniquet time to less than 2 hours to avoid tissue necrosis. Once bleeding is controlled well enough to evaluate the wound, it may be cautiously explored to evaluate for bleeding points. One must be very cautious if attempting to ligate these to ensure that adjacent structures, such as nerves, are not included in the ligature.