title: [Tourniquets, a drama in the infant: about 3 cases].
abstract: The time limit for the removal of a tourniquet is short; any delay in tourniquet deflation, especially if it exceeds the 3 hour limit, exposes to amputation hazards. Our objective was to report three cases of ischemic limb gangrene, caused by having forgotten to take a tourniquet off after a blood sampling, to inform healthcare professionals about the risk associated with that negligence. We encountered 3 cases of infants (2 three-month-old infants and 1 five-month-old infant), hospitalized in intensive care unit of Yalgado Ouédraogo University Hospital for upper-left limb swelling. Their medical history shows that there was a delay in tourniquet deflation after a blood sampling of 24 hours in two cases and of 48 hours in one case. Physical examination revealed a diffuse edema associated with upper limb gangrene spread to the mid-third of the upper arm, abolition of the ulnar and radial pulse as well as loss of sensation in the hand in 2 cases. In one case clinical signs were attenuated. The diagnosis of ischemic limb gangrene was confirmed in all cases. Laboratory examinations were normal. Two cases needed urgent trans-humeral amputation and one case needed debridement plus amputation of four fingers. The evolution was simple in all cases. Iatrogenic dry gangrene caused by a delay in tourniquet removal should never happen at hospitals. This can be guaranteed only by tightening up health management and by performing regular and accurate patient monitoring.
authors.affiliation: Service de Chirurgie Générale et Digestive du CHU-Yalgado Ouedraogo, 03 BP 7022 Ouagadougou, Burkina Faso.
authors.forename: Edgar
authors.initials: E
authors.lastname: Ouangré
authors.affiliation: Service de Chirurgie Générale et Digestive du CHU-Yalgado Ouedraogo, 03 BP 7022 Ouagadougou, Burkina Faso.
authors.forename: Moussa
authors.initials: M
authors.lastname: Bazongo
authors.affiliation: Service de Chirurgie CHU Pédiatrique Charles de Gaulle, 01 BP 1198 Ouagadougou, Burkina Faso.
authors.forename: Isso
authors.initials: I
authors.lastname: Ouédraogo
authors.affiliation: Service de Chirurgie Générale et Digestive du CHU-Yalgado Ouedraogo, 03 BP 7022 Ouagadougou, Burkina Faso.
authors.forename: Maurice
authors.initials: M
authors.lastname: Zida
authors.affiliation: Service de Chirurgie Générale et Digestive du CHU-Yalgado Ouedraogo, 03 BP 7022 Ouagadougou, Burkina Faso.
authors.forename: Daouda
authors.initials: D
authors.lastname: Ouedraogo
authors.affiliation: Service de Chirurgie Générale et Digestive du CHU de Tengandgo, 11 BP 104 Ouagadougou, Burkina Faso.
authors.forename: Adama
authors.initials: A
authors.lastname: Sanou
authors.affiliation: Service de Chirurgie Générale et Digestive du CHU de Tengandgo, 11 BP 104 Ouagadougou, Burkina Faso.
authors.forename: Gilbert Patindé
authors.initials: GP
authors.lastname: Bonkoungou
authors.affiliation: Service de Chirurgie Générale et Digestive du CHU-Yalgado Ouedraogo, 03 BP 7022 Ouagadougou, Burkina Faso.
authors.forename: Rodrigue Namékinsba
authors.initials: RN
authors.lastname: Doamba
authors.affiliation: Service de Chirurgie Générale et Digestive du CHU-Yalgado Ouedraogo, 03 BP 7022 Ouagadougou, Burkina Faso.
authors.forename: Nayi
authors.initials: N
authors.lastname: Zongo
authors.affiliation: Service de Chirurgie Générale et Digestive du CHU-Yalgado Ouedraogo, 03 BP 7022 Ouagadougou, Burkina Faso.
authors.forename: Si Simon
authors.initials: SS
authors.lastname: Traore
mesh_terms: D000671:Amputation, Surgical; D001800:Blood Specimen Collection / Q000009:adverse effects / Q000379:methods; D003646:Debridement / Q000379:methods; D004487:Edema / Q000209:etiology; D005734:Gangrene / Q000209:etiology* / Q000601:surgery; D006801:Humans; D007223:Infant; D008297:Male; D008318:Malpractice; D013997:Time Factors; D014111:Tourniquets / Q000009:adverse effects*; D034941:Upper Extremity / Q000098:blood supply / Q000473:pathology
keywords: Tourniquet; amputation; ischemic gangrene; limb