Surgical Tourniquets in Orthopaedics

The modern pneumatic tourniquet traces its roots to the time of the Roman Empire 199 BCE-500 CE, when non- pneumatic bronze-and-leather devices Fig. 1 were used to control bleeding from limb amputations during war. The goal was to save a life without regard for the limb. The term tourniquet, coined by Jean Louis Petit, is a derivation of the French verb tourner, meaning to turn. Petit described a new screw- like device that tightened a belt to stop arterial blood flow. With the advent of general anesthesia, Joseph Lister was the first to use a tourniquet to create a bloodless surgical field , in 1864. At the end of the nineteenth century, Friedrich von Esmarch advanced tourniquet design by devising a flat rubber bandage for exsanguination and to stop blood flow . In 1904, Harvey Cushing introduced the first inflatable pneumatic tourniquet, thereby permitting tourniquet pressure to be monitored and manually controlled.