Complications of the arterial tourniquet

The arterial tourniquet is commonly used for upper- and lower-limb surgery to optimise operating conditions. The tourniquet reduces bleeding, improves visualisation, and expedites surgical procedures. However, a number of complications, both localised and systemic, relate to tourniquet use. Although rare, these can be devastating, and may contribute to prolonged hospitalisation, and cause permanent loss of function, or damage to the limb. In order to minimise possible complications, it is important to understand the physiological effects of tourniquet use, and to follow recommended safety practices pertaining to their use. Complications of tourniquet use are due to mechanical compression of underlying structures, as well as ischaemia, and reperfusion effects. These result in localised, as well as systemic, complications.