The new digit tourniquet ForgetMeNot®

Abstract

Background: Digit tourniquets are widely used in the operating room and even more often in the emergency department to allow the exploration of injuries. A rolled surgical glove finger or silicone catheter placed at the base of the digit is a common method. However, rolled glove tourniquets are easily forgotten under the dressing and may then cause ischemia, which may require amputation. Silicone catheters are expensive single-use devices that may fail to provide effective exsanguination and must be removed by cutting, which may result in skin lesions. The ForgetMeNot^® digit tourniquet (Arex, Palaiseau, France) was designed to overcome these drawbacks. The objective of this study was to assess the use of ForgetMeNot^® in our clinical practice.

Hypothesis: The ForgetMeNot^® digit tourniquet is easy to position and remove, effective, and difficult to accidentally leave in place.

Material and methods: ForgetMeNot^® is composed of two solid cylindrical silicone strands emerging from a central crosspiece bearing two holes through which the ends of the strands can be threaded until stopped by beads on each strand. The device can be sterilised and re-used. It is easy to put in place and to remove. Threading the ends through the holes in the crosspiece forms two loops, which are passed around the tip of the finger. The device is then rolled down to the base of the digit, wrapping around itself and thus tightening gradually. At the end of the surgical procedure, pulling on the flat central crosspiece releases the device. ForgetMeNot^® was tested by junior and senior surgeons in 86 patients. The following were assessed: pain, tourniquet time, effectiveness of exsanguination, complications, and the learning curve.

Results: Positioning the device caused no pain. No patient reported paraesthesia. Remembering to remove the device was made easy by its bright blue or yellow colour. The pressure applied ensured effective exsanguination of the digit. In no case was cutting the device required for removal. Each device was sterilised and re-used several times.

Discussion: The new digit tourniquet ForgetMeNot^® is unlikely to be forgotten, effective, easy to use, re-usable, and associated with a low risk of skin lesions upon removal.

Level of evidence: III, retrospective uncontrolled study.

Keywords: Digit tourniquet; Exsanguination; Forgotten tourniquet; Pressure.