Tourniquet Release Prior to Dressing Application Reduces Blistering Following Total Knee Arthroplasty

Skin blisters occur in up to 20% of patients after total knee arthroplasty (TKA). Tourniquet release results in a limb volume increase of 10%. We hypothesized that releasing tourniquet before application of circumferential dressing will decrease blister formation. A prospective study was conducted on 135 consecutive primary TKAs. The tourniquet was released immediately after wound closure to allow for re-perfusion and then a dressing was applied. These patients were compared to a historical cohort of 200 primary TKAs, where the tourniquet was released after application of dressing. There was a significant difference in the incidence of blisters between the two groups [Late 7.5% (15/200) vs early release 2.2% (3/135) P = 0.028]. Releasing the tourniquet prior to dressing application has reduced the incidence of blistering following TKA.