Creation of a blood free surgical field during orthopedic, vascular and plastic surgery has been the standard of care for over 100 years. The initial device was described by Friederich August von Esmarch in 1873 and is still being used today as the Esmarch bandage. In 1908, Dr. Harvey Cushing first described the use of a pneumatic tourniquet to occlude the blood flow into the scalp during brain surgery. Combination of an Esmarch bandage for squeezing the blood away from a limb (exsanguination) and a pneumatic tourniquet to occlude arterial blood flow is currently used in over 90% of limb operations. The use of a pneumatic tourniquet to occlude the arterial blood flow into a limb is associated with a number of side effects and adverse reactions. The side effects and adverse reactions may include tourniquet paralysis, which is transient or permanent nerve damage caused by the mechanical affect of the wide tourniquet cuff on the nerve. (Ochoa at el. Anatomical changes in peripheral nerves compressed by a pneumatic tourniquet. J Anat. 1972; 113(Pt 3):433-55.) In addition, side effects and adverse reactions may include skin lesions, which are skin abrasions or liquid blisters at the site of tourniquet placements (tourniquet burn) and tourniquet pain, which is tenderness at the site where the tourniquet was placed, that may last for days or even weeks.
More recently devices combining the exsanguination effect of the Esmarch and the blood flow blocking of a tourniquet are being used. These exsanguination tourniquet devices may be difficult to use when a patient is under anesthesia resulting in a patient's finger or toe being improperly inserted into the exsanguination tourniquet. The misplacement of a finger or toe occasionally leads to loss of operating room time and frustration of the surgical team. The present invention overcomes the shortcomings of the prior art and others.