Injury, Int. J. Care Injured 33 (2002) 76–77

The unforgettable finger tourniquet

Sarah Tucker a,*, Peter Christian Harris b

a Department of Plastic Surgery, SHO in Plastic Surgery, Frenchay Hospital, Frenchay, Bristol, UKb SpR in Orthopaedic and Accident Surgery, Mersey Deanery, UK

Accepted 12 June 2001

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Fig. 1. A Derma Prene™ glove ready for use as a finger tourniquet. The glove used should be approximately the size of the patient’s hand andthe corresponding finger is cut off, applied to the finger, and rolled down.

For surgery confined to the finger, a finger tourni-quet is often preferred over an arm tourniquet sinceit avoids unnecessary tissue ischaemia and, for proce-dures carried out under digital nerve block alone, willbe tolerated by the patient for longer. There are com-mercially produced finger tourniquets [1,2], but thesetend to be expensive compared with using simpledevices constructed from equipment that is readilyavailable in any operating theatre.

A simple and popular method of making a fingertourniquet involves cutting the finger off from a sur-gical glove approximating to the size of the patient’s

hand, cutting a small hole in the tip, and applying itto the patient’s finger. It is then rolled down so thatit exsanguinates the finger and becomes a tourniquetat the base [3,4]. There were theoretical concernsraised about excessive pressure under the tourniquet[5], but this has been disproved in experimental stud-ies measuring pressure with transducers [6,7]. Theseshowed that if the glove used is the same size as thepatient’s hand the mean pressure generated was 355mmHg, and uniformly less than 500 mmHg indepen-dent of the operator’s experience of the technique.

Most surgeons wear and therefore make theirtourniquets from gloves that are clear or flesh-coloured. These tourniquets are, in effect,camouflaged. There have been a small number ofcases where the tourniquet has been inadvertently lefton, resulting in necrosis of the digit [8,9].

* Corresponding author. Present address: 1 Hillsborough, MainRoad, Temple Cloud, Bristol BS39 5BL, UK. Tel.: +01761-452295.

E-mail address: sarahtucker@doctors.org.uk (S. Tucker).

0020-1383/02/$ - see front matter © 2002 Elsevier Science Ltd. All rights reserved.PII: S 0 0 2 0 -1383 (01 )00095 -X

S. Tucker, P.C. Harris / Injury, Int. J. Care Injured 33 (2002) 76–77 77

Fig. 2. A bright green glove used as a finger tourniquet would be difficult to miss at the end of an operation.

We suggest using a coloured glove instead. The ma-jority of latex free gloves are bright green (Fig. 1) e.g.Derma Prene™ (powder free), produced by AnsellMedical.

The surgeon who applies a tourniquet should alwaysensure that the theatre staff document the time ofapplication. This should prompt a reminder to removethe tourniquet at the end of the procedure in order tocomplete the documentation. However, the use of amore clearly visible glove for the finger tourniquet(Fig. 2) would make it extremely unlikely to be left on,even if these measures fail.

Acknowledgements

Department of Medical Illustration, Frenchay Hospi-tal.

References

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