TOURNIQUET-RELATED COMPLICATIONS IN EXTREMITY INJURIES: A SCOPING REVIEW OF THE LITERATURE anaixacur@gmail.com

PE126

TOURNIQUET-RELATED COMPLICATIONS IN EXTREMITY INJURIES: A SCOPING REVIEW OF THE LITERATURE

7

Mexico

Oral or Poster

Tourniquet use has been pivotal in preventing avoidable deaths in both military and civilian settings, with origins dating back to ancient civilizations. Since the launch of the Stop the Bleed campaign, their application has increased, raising concerns about potential complications, including limb ischemia, amputation, nerve injuries, post-tourniquet syndrome, and thromboembolic events. Prolonged application in emergencies may exacerbate these risks. Given the growing global use of tourniquets, this scoping review aimed to synthesize existing evidence on complications associated with tourniquet use for extremity injuries and identify knowledge gaps to guide future research.

A literature review (2016–2024) was conducted addressing tourniquet use in civilian or military patients with extremity injuries. Searches were performed in PubMed, ScienceDirect, and Cochrane databases

The initial search yielded 1,398 articles. Following the PRISMA-ScR 2018 checklist, 1,343 were excluded due to duplication or irrelevance. Of the remaining 55, 37 were excluded after abstract review for not meeting inclusion criteria. Eighteen full-text articles were reviewed, and 10 were excluded for insufficient data, leaving eight studies for detailed analysis. Nerve palsy emerged as the most prevalent complication linked to prolonged use.

Tourniquets remain essential for controlling life-threatening hemorrhage; however, their increased use necessitates improved training to ensure appropriate application and minimize complications. Future research should focus on: (1) prospective randomized trials comparing tourniquets to alternative hemorrhage control methods; (2) validated scoring systems predicting complications and amputation risk; (3) enhanced training for lay responders; and (4) evidence-based guidelines on tourniquet removal or conversion timing.