PriMera Scientific Surgical Research and Practice (ISSN: 2836-0028)

Mini-Review

Volume 7 Issue 1

Is the “Sixty to Ninety Minutes” Rule for Upper-limb Tourniquet use Valid for Nigerian Hand-Trauma Patients? — A Call for Local Data and Possible Safety Changes

Anthony S Ezekiel*

December 31, 2025

Abstract

Tourniquets provide a bloodless field in hand surgery but can cause nerve injury. While international guidelines cite 60 minutes as a warning and 90 minutes as a maximum continuous inflation time, clinical experience at Abubakar Tafawa Balewa University Teaching Hospital (ATBUTH), Bauchi, suggests that neuropraxia do occur when inflation lasts around 60-70 minutes. These editorial reviews relevant literature, considers local risk modifiers, and argues for both immediate precautionary practice changes and a prospective Nigerian study to define safe limits for our population.

References

  1. Masri B., et al. “Tourniquet-induced nerve compression injuries: mechanisms and prevention”. BMC Biomed Eng 2 (2020): 5.
  2. Olivecrona C., et al. “Electromyographic changes after routine tourniquet use in upper limb surgery”. J Hand Surg Eur 38.5 (2013): 513-7.
  3. Chang J., et al. “Management of tourniquet-related nerve injury: a systematic review”. EFORT Open Rev 7.9 (2022): 651-60.
  4. Liu G., et al. “Best evidence summary for the safe use of pneumatic tourniquets”. BMC Surg 24.1 (2024): 114.
  5. Drolet BC., et al. “Evidence for safe tourniquet use in 500 consecutive upper extremity procedures”. Hand (N Y) 9.4 (2014): 494-8.
  6. Kanchanathepsak T., et al. “Limb occlusion pressure versus standard tourniquet inflation pressure in minor hand surgery: a randomized controlled trial”. J Orthop Surg Res 18.1 (2023): 539.
  7. Liu G., et al. “Best evidence summary for the safe use of pneumatic tourniquets”. BMC Surg 24.1 (2024): 114.
  8. Ajibade A., et al. “A survey of the use of tourniquet among orthopaedic surgeons in Nigeria”. Niger Postgrad Med J 28.2 (2021): 133-138.