Impact of Prolonged Tourniquet Time on Wound Healing in Orthopaedic Surgeries: A Retrospective Cohort Study

Introduction: Tourniquet application is routinely used in orthopaedic surgeries to reduce intraoperative blood loss and enhance surgical field visualisation. However, prolonged use of it may adversely affect tissue perfusion and delay wound healing. Aim: To evaluate the association between tourniquet duration and wound healing in patients undergoing orthopaedic surgeries. Materials and Methods: The present retrospective cohort study was conducted at Mahatma Gandhi Medical College and Research Institute, Pondicherry, India, over a period of six months involving 40 patients who underwent orthopaedic procedures involving tourniquet use. Participants were categorised into two groups based on tourniquet time: less than 120 minutes (n=23) and 120 minutes or more (n=17). Delayed wound healing was defined as wound dehiscence requiring clinical intervention, delayed suture removal beyond postoperative day 12, or the presence of a surgical site infection confirmed clinically or microbiologically. Delayed wound healing incidences were compared between groups using Fisher’s-exact test. Results: A total of 40 patients were included in the study, of whom 7 were females and 33 were males. Delayed wound healing occurred in 4 out of 17 patients (23.5%) with tourniquet time ≥120 minutes, while none of the patients in the <120- minute group experienced delayed healing. The difference was statistically significant (p=0.026). Conclusion: Prolonged tourniquet application of 120 minutes or more is significantly associated with delayed wound healing in orthopaedic surgeries. Careful consideration of tourniquet duration is warranted to minimise postoperative complications and support optimal healing.