Haemostasis
Rule out any coagulation disorders prior to surgery – or medication that affects coagulation.
Elevation of limb prior to procedure for 3 mins reduces blood.
Exsanguination via pressure bandage further reduces blood in limb
Tourniquet
Thigh tourniquet – pressure should be 200mgHg over systolic pressure
Adrenaline vasoconstriction and increase duration of local anaesthetic. Needs to be used with caution in digits.
Ligation of any vessel that is bleeding
Post operative bleeding – use eg calcium alginate sponges
Contraindications for use of tourniquet:
• sickle cell disease
• previous vascular bypass surgery
•
Complications of tourniquet use:
• tissue necrosis
• inflammation
• paralysis
• thrombosis
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