Reusable Tourniquet Cuffs Cleaning Instructions

Reusable tourniquet cuffs are supplied as non-sterile products, and are intended to be used for multiple surgical procedures. Reusable tourniquet cuffs can be reused with confidence and safety if they are cleaned and inspected properly between each surgical procedure. Each tourniquet manufacturer and 2009 AORN Recommended Practices for the Use of the Pneumatic Tourniquet in the Perioperative Practice Setting (http://www.tourniquets.org/aorn.php) provide guidelines for cleaning and inspection of reusable tourniquet cuffs prior and after use.

In general, a reusable tourniquet cuff may be cleaned in lukewarm water and an US Environmental Protection Agency (EPA) registered, intermediate-level, tuberculocidal disinfectant. . The cuff should then be rinsed thoroughly because cleaning solution residue may cause skin irritation, increase the chance of allergic reaction, and decrease the life of the cuff and bladder. A soft hand brush may be used to remove encrusted material. The cuff may also be wiped with isopropyl alcohol.

All tubing should be cleaned, rinsed, and dried between patients and before storage, using an EPA-registered, detergent/intermediate-level disinfectant. Care must be taken to prevent introduction of solution into the ports. Water in the ports contributes to microbial growth. Subsequent deflation of wet bladders may cause minute droplets of solution to be forced into the tourniquet regulating mechanism, causing damage.

The cleaned cuff and tubing should be allowed to drip dry at room temperature. Any increased temperature during cleaning may cause unevenness or rippling in the cuff material, rendering it unsuitable and unsafe for further use.

It is important to note that if a cuff is unable to be cleaned adequately, it should be discarded in an appropriate receptacle.

Finally, before a cuff can be used, it must be thoroughly inspected. For example, the following is a list of items that can be used for cuff inspection prior to use:

1. Has the cuff been cleaned thoroughly after the previous use?
2. After cleaning, is there any obvious discoloration remaining due to blood or residue remaining from previous use that could be a potential source of contamination?
3. Is there any physical damage to the cuff (for example, rips, tears, holes, unevenness or rippling along the length of the cuff when laid flat)?
4. Is (are) the positive-locking hose connector(s) on the valve stem(s) bent, broken or worn, or does the black o-ring on each connector appear to be cracked, damaged or missing?
5. Is the colored ribbon torn or the ribbon stitching broken?
6. Is the hook and loop (Velcro) material torn or is any of the stitching around the material broken or fraying?
7. After cleaning, is more than 25% of the (Velcro) contact closure material embedded with fibers that cannot be removed?
8. Connect the cuff to a tourniquet instrument, wrap the cuff onto itself, and inflate the cuff. Are there any leaks in the cuff or connectors? Some recent tourniquet instruments have advanced leak detection for automatically detecting leaks in cuffs during and after surgical operations.
9. Is there any other physical change or damage to the cuff that would compromise the cuff's ability to maintain pressure and stop blood flow during a surgical procedure?
10. If any of the above conditions are present the cuff is no longer usable and should be discarded. Possible consequences of using a damaged cuff include the possibility of catastrophic injury, including death, to the patient due to the release of blood into the surgical site.

References for educational viewing only

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AORN. Recommended Practices for the Use of the Pneumatic Tourniquet in the Perioperative Practice Setting, Ass’n of periOperative Registered Nurses, 2009.