Modified use of extremity tourniquets for burn wound debridement.

A modified technique of tourniquet use for sequential burn wound debridement is described. With partial exsanguination of the extremity, intermittent release and rapid reinflation of the tourniquet will allow the surgeon to assess the adequacy of debridement and to decrease reactive hyperemia and blood loss during the excision. This controlled method to decrease blood loss in the upper extremities during debridement, in combination with epinephrine soaks and compressive wraps, can be mastered so that transfusion is not necessary during excisions of less than 12% total body surface area. Visible hemostasis is assessed with this method before final application of skin grafts to optimize skin graft revascularization and minimize wound hematomas.