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Hand Surgery Diagnosis and Operations - Exsanguination

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In order to reduce the risk of damage to healthy, neighboring structures (nerves, vasculature, tendons) during hand surgery, so-called exsanguination of the hand or arm is necessary. The entire arm is wrapped (distal to proximal) in a rubber bandage, thereby pressing the blood towards the shoulder. Then an arterial tourniquet or cuff is pumped up on the upper arm so that the blood can no longer flow into the arm, allowing the structures of the arm and hand to be well displayed and thereby protected during the surgery.

As a rule, a maximum pressure of 300 mmHg is used with the cuff, and sometimes less depending on the age and blood pressure of the patient. The duration of exsanguination should be limited to a maximum of two hours. As a rule, this time period is sufficient to complete the portion of the operation requiring exsanguination.

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