Tourniquet injuries : pathogenesis and modalities for attenuation

Although it is widespread in orthopaedic surgery, tourniquet use is associated with appreciable morbidity and even mortality. We review the use of tourniquets, highlighting how an understanding of their design and application can reduce the complications and injuries associated with their use. We also review the attempts being made to modulate these injuries through physical and pharmacological advances, in particular looking at the phenomenon of preconditioning.